2014 Spring Forum

June 12, 2014

Society Registration
Presented by Robin Telasky

  • Society registration has been approved. The organization is now “The Health Coalition of Alberta Society.” Corporate registries required the Coalition to choose a new name.
  • The goal is to transition to the new Society by October 1, 2013.
  • New branding will take place over the next few months (i.e., logo, website, etc.).
  • If you are interested in participating on the Board or on working committees, please contact Robin Telasky at .
  • New governance structure:The Steering Committee will transitionto a formal Board of Directors; there will be new decision-making processes and a membership policy
  • New “Objects of the Society”
  • Improve quality of life of patients and families through optimal health care public policy
  • Encourage, foster and develop among healthcare stakeholders, knowledge of the importance of actively learning and engaging in public policy discussions and decisions relating to health care and other determinants of health
  • Influence, support and cooperate with public and private agencies, governments, provincial and national organizations so as to positively influence the development of legislation and policy
  • New Membership Structure (Voting vs. Non-Voting)
  • Voting: Full Membership – Organizations (Non-profit, health-related organizations with a mandate that aligns with the Society); Full Membership (Individuals)
  • Non-Voting: Affiliate Membership (Organizations – non-profit organizations with an aligned mandate with the Society), or Supporter Membership (Non-profit or for-profit organizations or companies who support the Society’s mission)
  • Membership (calendar year): Applicants can apply to be a member from January 1, 2015
  • Full Membership – Organizations:
  • Under 100 members: $50.00
  • 101-1000 members: $100.00
  • 1001 or more members: $250.00
  • Full Membership – Individuals: $25.00
  • Affiliate Membership: $100.00
  • Supporter Membership: $500.00

Pharmaceutical Strategy and Programs Policy
Presented by Angeline Webb

  • The Health Coalition of Alberta’s (formerly Creating Synergy)pharmaceutical strategy paper was approved at the 2013 Fall Forum
  • The issues identified in the pharmaceutical strategy include the following:
  • Program limitations and barriers
  • Review of new drugs for formulary
  • Segregation of pharmaceutical decisions – decisions often made on a financial basis not on the best decision for patients
  • Drug prescribing and monitoring process
  • Lack of stakeholder engagement
  • Policy recommendations:
  • Develop a drug program that more appropriately meets optimal health needs and outcomes of Albertans
  • Drug review changes are needed
  • Drug utilization programming essential to address prescribing/monitoring issues
  • Engagement of Albertans (patients/consumers) is a promise that must be kept
  • This paper recommends that the Drug Program Principles should be based on what Albertans and patients value most: comprehensive drug benefits; universal; accessible; efficient; effective and safe.

Next steps and Actions for the Health Coalition

  • Policy development
  • Stakeholder engagement
  • Government engagement (meeting with Minister of Health – yet to occur; actively engaged with Alberta Health – Pharmaceuticals & Supplementary Health Benefits)

Our Question for Action: Albertans have asked and were told they would be engaged in meaningful discussions regarding proposed pharmaceutical and other healthcare strategies. The Health Coalition of Albertaand other Albertans want to be involved in discussions. What can we do to make this happen?

Discussion / Q&A

Question: How is the Health Coalition ensuring that what they are asking government for is based on the interests of the Coalition?

The Health Coalition has gone to great lengths to ensure that what is being asked for is based on evidence, best practice, and success from other jurisdictions. Improved access to pharmaceuticals would benefit all Albertans.

Question: What are some other barriers to accessing pharmaceuticals?

PCNs are insisting on referrals so patients must find a doctor first. However, getting in to see the right doctor can be a challenge for some people. Or, patients may go to a doctor who does not believe a pharmaceutical will work and will not prescribe it.

Comment: Lack of education

People just do not realize what is happening. How much can you tell the public and how? It might be helpful for the Coalition to approach the media and find a way to tell this story.

Comment: Election Leadership

This issue might be a good opportunity to approach the Minister, ask these questions, and also offer to help the Minister find solutions.

Examining Alberta’s Availability & Access to Health Care: Focusing on Primary Health Care and Continuing Care

Presented by Katharina Kovacs Burns, Health Coalition of Alberta Co-Chair; University of Alberta

  • In the 2013 Membership Survey, CS members identified two important issues:
  • Access to primary health care and continuing care
  • Patients should be the prime focus in the changing structure of health care services in Alberta
  • Alberta’s recent policies and plans:
  • Alberta Health Act 2014
  • Alberta’s Health Charter 2014
  • The Building Alberta Plan 2014-2017
  • Alberta Health Services Health Plan and Business Plan 2013-2016
  • Alberta’s Social Policy Framework 2013
  • Becoming the Best: Alberta’s 5-year Health Action Plan 2010-2015
  • Vision 2020
  • Irene Martin(Alberta Senior Citizens’ Housing Association) said the government has organized three “Continuing Care Forums” to consult organizations and patient groups
  • Recommendations
  • Coordinate Primary and Continuing Care with other areas across Continuum of Care
  • Patient or person-centred care
  • “Triple Aim” – evaluation of quality outcomes, better care experiences and lower per capita costs
  • Public awareness and consultation re: Alberta Primary Care Strategy
  • Revise Continuing Care strategy – case management and lower service costs
  • Electronic medical records and integrated care pathways across Continuum of Care

Discussion Question: Are there other issues or changes in service delivery that impact on access to care that we are not aware of or have not identified here?

RESPONSES – other issues/recommendations:

  • Transportation and type
  • Dental, optometry
  • Access for disabilities
  • Burden on NGOs/families
  • No services (Taxi, bus)
  • Parking
  • Fee for service
  • Location of services
  • Utilizing other approaches – telehealth
  • Other supports – i.e. employment
  • Vulnerable – mobile workers
  • Rare disorders/diseases
  • Stigma around certain conditions
  • Consent for health record access
  • Public awareness, including about health records
  • Mental wellness – lack of awareness
  • Illness response versus wellness
  • Mental illness – integrate as medical condition
  • Health care navigation
  • Ripple effects → families
  • Resources/partnerships
  • Equity framework?
  • Plan for older seniors 80+
  • Co-ops
  • Portal/Directory
  • Alberta Support Centre

Recommendations re MEASURES:

  • Health promotion program – public, NGO/community, integrated
  • Physical evaluations
  • How do we reach populations to measure?
  • Neighborhood outreach – i.e. Community leagues and other networks.

AFTERNOON SESSION

Action for Community Care

Presented by The Hon. Fred Horne, Minister of Health

The Minister provided an update on the government’s three health priority areas and discussed how to expand care.

1. Primary health care

  • The Minister discussed the different models of delivering health care (PCNs, FCCs, etc.). He said the government has made progress in expanding care to people in their home communities in order to achieve a higher level of wellness.
  • The goal is having people belong to a team that represents multiple disciplines where they live at hours when people can go to access care.
  • For example, pharmacists delivered 1/3 of flu shots last year. The government intends to continue expanding scope to other health professionals in the system such as optometrists AND paramedics (AKA “Full Scope of Practice” opportunity).
  • The Minister invited input from the Health Coalition to provide input into the government’s primary health care plans.

2. Continuing Care

  • The government is working on a new continuing care policy for Alberta.
  • The new strategy will include more home care and informal supports in the community.
  • The government is looking at a new funding model to “stop funding beds and start funding the needs of people we serve.” He said opening new beds is costly and most people want to be at home.
  • The recent Health Quality Council of Alberta report looked at quality assurance in continuing care. Some suggestions were to have health operators be subject to the same contractual obligations and that all facilities should meet national standards.
  • The Minister said he could use assistance in moving end-of-life care forward. He said the government is looking at using primary health care as a vehicle to deliver palliative care at home but training and education are needed to help support this.

3. Mental Health

  • The government’s mental health priorities are: 1) continue expanding resources in hospitals as people need them and 2) support transitions back to the community.
  • The government is committed to helping young people. There is now permanent funding in 183 schools for mental health programs, which will help early detection and intervention.

Conclusion: We need people who will stand up for community-based care to take their eyes off the bricks and mortars and think about people living in their communities to achieve the best levels of physical, mental health.

Discussion / Q&A

Question: Where do you see the community support from the not-for-profit perspective? Where do NGOs fit into the community component aspect?

The vehicle needs to be partnerships between the health care system and people seeking community care. There need to be more conversations about how NGOs can be empowered to provide community care. The patient should be an equal member of a team along with doctors, nurses and other regulated professionals.

Question: Will organizations be consulted in the process of continuing care for NGOs who work in seniors homes, etc.?

The Minister replied yes. He said one example is the Continuing Care Forum, a small group that has been developing some basic policy concepts, and there will be other opportunities for more consultation. The Minister is trying to find a way where people not only talk about money but also talk about how this basic policy document will empower non-profit organizations to do what they are already doing in the local community.

The primary health care strategy took about 1.5 years to develop and this continuing care document may be the same, but there will be more of a shift to community care.

Question: How can organizations find out how they can contribute and become engaged in the process better?

The government is starting to change its attitude about engagement. It is also rethinking the role of the Health Advisory Councils (HACs). These councils will become a much bigger part of how people get involved, provide feedback and give ideas. At a service delivery level, AHS needs a place to go to get feedback. Some changes in the fall will bring the HACs more closely under the provincial government and this might be the primary vehicle. There will also be more deliberate outreach from AHS as well.

Question: World Elder Abuse Day is coming up. How is the investigation of elder abuse coming along?

The Minister said the Protection for Persons in Care Act annual report is being released today, and it shows a 26% reduction in the number of founded allegations of elder abuse. The number of reports of abuse has increased. The majority of reports are from front line workers. People are less afraid to speak up.

Pathways to Seniors’ Health

Presented by J. Lawrence Tymko

  • We need to rethink our strategy for addressing the whole-person needs of the elderly.
  • Seniors are going to experience at least one or more chronic conditions with aging, but they are all capable of an optimal state of well being – social, physical, intellectual, cultural, emotional and environmental.
  • Seniors require an integrated services pathway to access appropriate services.
  • Mr. Tymko proposed a solution called ABISS (Alberta Integrated Services for Seniors).
  • ABISS would be a single-entry, highly coordinated, seamless, senior-centric arrangement of advisory, referral and direct delivery of services related to age-friendly housing, community, health care supports.
  • The Minister is supportive of this idea, and Mr. Tymko said he is waiting to field test it.
  • ABISS would have three service levels:
  • Level 1- information advisory
  • Level 2 – referral/coordination of linkages
  • Level 3 – integrated service management/monitoring

Health Quality Council of Alberta

Presented by Dr. Tony Fields, MD; Chair, Health Quality Council of Alberta

1) About the Health Quality Council of Alberta (HQCA)

  • Has existed for 10 years. The Council’s principal object is topromote and improve patient safety and health service quality across Alberta.
  • The Council offers an objective perspective, detached from the government. It measures, monitors and assesses patient health safety and quality; improves health safety; assists in implementation of activities, strategies and mechanisms intended to improve health service quality; and, surveys Albertans.
  • It does not deliver any services. This has to be achieved through others.
  • Goal: to be more proactive than reactive
  • Recommendations and Issues:
  • Dr. Fields provided a series of recommendations and issues related to continuing care.Some of these are highlighted below.

AHS should develop a plan with timeframes to move all legacy continuing care contracts over to the standardized master services agreement.

Improve auditing processes in continuing care. The current processes result in redundancies and inefficiencies at the provider, health authority and ministry levels.

Improve continuous performance.

Continuing care lacks a standardized, consistent and province-wide approach to administering client and family experience surveys.

2) Report – HQCA Review of AHS Policy

Continuing Care Waitlist: First Available Appropriate Living Option

  • Some of the report recommendations included the following:
  • Give patients and caregivers reasonable timelinesto make decisions about options
  • Create a decision support tool that takes people’s needs into consideration
  • Create a resolution mechanism when the presented options are not acceptable
  • Highlight the principles of inclusion of patients and caregivers
  • Develop a formal ethical framework application

Discussion / Q&A

Question: Is the Health Quality Council arm’s length from the government?

The Council is an objective body and is as arm’s length as it can be when working with government. The media likes to call the Council a “watchdog” but it only makes recommendations and sometimes monitorsimplementation. It is not the auditor general.

Question: Will the Health Quality Council respond to a request from a Minister or AHS?

By statute, the Council must respond to the Minister and AHS. It can also respond to other people in the health services area, e.g., regulatory body of physiotherapists.

Question: Is the Council following some standards for accessibility for people with disabilities and how will the medical facility’s accessibility be measured?

The Council does not assess facilities like accreditation does. Accessibility – in the public eye – means timeliness, but there are many other important factors such as geography, cross-cultural barriers, access across age groups, levels of disability, etc. Reducing disparity is one of the ultimate goals of improving accessibility

Question: Are you able to contract to private providers?

It depends. The Council does not monitor the contract but outlines the principles the contracts should follow. Many recommendations in the HQCA report describe what should be reported, assessed, etc.

SPRING FORUM 2014 ATTENDEES

Members

# / First Name / Last Name / Organization
1 / Minhas / Ali / Alberta Committee of Citizens with Disabilities
2 / John / Bachynsky / Seniors Community Health Council of Edmonton
3 / Jackie / Beaton / Alberta Committee of Citizens with Disabilities
4 / Katharina / Kovacs Burns / University of Alberta; Health Coalition of Alberta
5 / Bernice / Cassady / CARP: A New Vision of Aging for Canada
6 / Mary / Chibuk
7 / Teren / Clarke / Canadian Paraplegic Association – Alberta
8 / Jenny / Grant / Alberta Senior Citizens’ Housing Association
9 / Simon / Habegger / Canadian Diabetes Association
10 / Julie / Kelndorfer / MS Society of Canada
11 / Brandi / La Bonte / Parkinson Alberta
12 / Austin / Mardon
13 / Irene / Martin / Alberta Senior Citizens’ Housing Association
14 / Bev / Matthiessen / Alberta Committee of Citizens with Disabilities
15 / Tom / Perkins / Alberta Porphyria Society
16 / Shirley / Philips / The Arthritis Society – Alberta and Northwest Territories
17 / Catherine / Ryan / Individual Advocate
18 / Kris / Swaren / Fibromyalgia Society of Edmonton and Area
19 / Jung-Suk / Ryu / CNIB
20 / Katherine / Watson / Alberta Hospice Palliative Care Association / National Health Practitioners of Canada
21 / Angeline / Webb / Canadian Cancer Society – Alberta/NWT Division
22 / Teren / Clarke / Canadian Paraplegic Association – Alberta
# / First Name / Last Name / Organization
23 / Robin / Telasky / Health Coalition of Alberta
24 / Jacquie / Béasse / Health Coalition of Alberta

Non-Members

# / First Name / Last Name / Organization
25 / Brian / Canestraro / Gilead
26 / Brian / Carter / LEO Pharma
27 / Emanuela / De Franco / GSK
28 / Dan / Ekstrand / Novo Nordisk Canada
29 / Michele / Evans / Government of Alberta
30 / Tyler / Rogers / Gilead
31 / Bill / Gowen / sanofi-aventis
32 / Michael / Houlahan / Sandpile Inc.
33 / Jeff / Kasbrick / Janssen, Pharmaceutical Companies of Johnson & Johnson
34 / Danny / Labbe / Boehringer Ingelheim
35 / Robert / Lee / Takeda
36 / Orrin / Lyseng / Alberta Association on Mental Illness and Mental Health (AAMIMH)
37 / Kim / Shulha / Novartis
38 / Cindy / Shurman / Abbvie
39 / Carmen / Wyton / Chair, Premiers Council on the Status of Persons with Disabilities, Government of Alberta; Vice-President, Stakeholder Relations & Partnerships at CAREERS: The Next Generation

Guest Speakers

# / First Name / Last Name / Organization
40 / The Hon. Fred / Horne / Minister of Health, MLA, Edmonton-Rutherford
41 / J. Lawrence / Tymko / Past Chair, Greater Edmonton Health Advisory Council
42 / Dr. Anthony (Tony) / Fields / University of Alberta, Alberta Health Services, Health Quality Council of Alberta, pCODR