CHA: Advocating for Canadians

2. CHA: Advocating for Canadians Pamela C. Fralick, President & CEO, M.A., ICD.D Canadian Association of Optometrists 28 January 2011

3. Today: 5 Points • Why Me? • Why CHA? • Today’s Environment • GR Strategies • Thoughts for CAO Dialogue!

4. 1. Why Me? Past CEO, CPA + HEAL Chair/Co-Chair + CCPH21 Co-Chair + CAMH; IMHR + International + Sport; Culture; Outward Bound =NETWORKING, PARTNERSHIPS, BLURRED BOUNDARIES

5. 2. Why CHA? • Longevity... • Credibility... • Accomplishments... • Relevance.

8. CHA’s Mission CHA is a leader in developing and advocating for health policy solutions that meet the needs of Canadians.

9. CHA’s Vision “CHA is a the recognized champion for a sustainable and accountablequality health system that provides access to a continuum of comparable services throughout Canada, while upholding a strong, publicly funded system as an essential, foundational component of this system.”

10. CHA’s History • Formed as the Canadian Hospital Association in 1931 - active champion of Canada’s health system for 80 years • Major player/lead: • uniform accounting system for Canadian hospitals; • first national, government-funded hospital insurance system; • standardized emergency codes • Key influencer in the debates that led to medicare and the Canada Health Act • Gave rise to CCHL (formerly CCHSE), Accreditation Canada and ACAHO

11. CHA’s Uniqueness • Sole federation of provincial and territorial health associations and organizations representing the breadth of the health system. • Proponent of the full continuum of care - name changed in 1995 to the Canadian Healthcare Association; amalgamation with the Canadian Association for Community Care in 2006. • Draws its strength/voice from those at its table – 13 provinces and territories. • Does not represent a single voice or constituency, other than the Canadian public, through its members.

12. CHA Activities • Policy development • Advocacy • Communications • Distance learning • Conference services ~20 Staff. ~150 Education Consultants

13. CHA’s Strategic Directions • CHA is an ADVOCATE for an accessible, high-performing health system. • CHA is a CATALYST for progressive and innovative debate. • CHA is a LEADER in health policy development. • CHA actively fosters a unified member VOICE through its organizational strength.

14. Advocacy/Policy:Cycle of activities – advocating for equitable health care for Canadians The advocacy year for CHA begins in July, not January, and continues until Parliament recesses in June of the following year. July/August ― Preparation of CHA’s pre-budget brief to the Finance Committee September ― Submission of pre-budget Brief September/October ― Response to the Speech from the Throne (if required) November ― Presentation of Pre-Budget Brief to the Finance Committee February/March ― Response to the Federal Budget All year - Presentations to House of Commons and Senate Committees - Monitoring the work of the House and Senate - Meetings with Senior Politicians and Departmental Officials And then there are election years!

15. Advocacy/Policy “Menu”…Challenge! Fiscal federalism Funding Mechanisms (CHT,CST, Accords) Electronic Health Record Public/private mix Health Human Resources Regulatory issues (drugs, appliances) Long-term care Home care Respite care

16. Issue “Menu” (Cont’d) Aboriginal Health Research Unregulated Healthcare workers Pandemic planning/ Public Health Agency initiatives Mental Health Prevention and Promotion PHC Pharmacare Patient Safety And…”Emerging Issues”….!

17. Current Priority Focus Health System Sustainability! • FUNDING (models, transfers, 2014, GST) • HEALTH HUMAN RESOURCES (data, integration/coordination, QW-QHC) • PHARMACARE (position statement, NPS, generics) • WELLNESS (disease prevention, health promotion, public health) • CONTINUING CARE (home care, long term care, respite care) • LEADERSHIP (political, governance, executive)

18. Funding Accomplishments • In 1991, negotiating an 83% GST rebate for hospitals • In 1995, insisting that health had to be a visible part of the federal transfer, resulting in the proposed Canada Social Transfer becoming the Canada Health and Social Transfer (CHST), • In 1995/96, successfully advocating that the CHST transfer become a per capita transfer as opposed to being disadvantageously weighted against BC, Alberta and Ontario,

19. Funding Accomplishments (cont’d.) • In 1998/99, increasing the health budget from $1B to $11.5B over 5 years, and in 2000, influencing the additional investment of $2.5B for health and education. • In 2004, playing a seminal role in the establishment of a 6% escalator in health funding. • Active and effective lobbying to maintain the 6% through fiscal restraint/recession • Release of $500M for E-Health from ’09 Budget

20. 3. Today’s Environment • 2014 TRUMPS ALL...IN MEDIA • BUDGET • FEDERAL ELECTION • FEDERAL HEALTH LEADERSHIP....

21. Today’s Environment... • YET NOTABLE POLITICAL ACTIVITY (palliative; pandemic; mental health; ACHDHR; Lib & NDP platforms) • HEALTH RESURFACING AS #1 • CMA ACTIVITY

22. Today’s Environment.... • Media: Maclean’s, G&M, Hy Solomon to Picard... • International: USA; Comparative studies; OECD recs. • Hot issues: LTC; pharmacare; patient-centred care

23. 4. GR Strategies • REACTIVE AND PROACTIVE, depending on need • ALL PARTIES; 2 LEVELS OF GOV’T • POLITICAL STAFF andBUREAUCRATS • PRE-BUDGET SUBMISSION

24. GR Strategies... • WITNESS at every relevant Committee • Art and Science of RELATIONSHIP BUILDING • MEMBERS– Prov/Terr... • Media – establish relationships – prepare sound-bites, e.g......

25. Globe & Mail, Tuesday, Jan. 25, 2011 11:55PM EST “Kuwaiti patients, Canadian care: Hospital executives seek revenue in foreign lands.” LISA PRIEST

26. ...said Pamela Fralick, President and chief executive officer of the Canadian Healthcare Association.... “No Canadian patient can become a second-class citizen just because of international purchasing power.”

27. GR Strategies... • EDITORIAL BOARDS • FBLTC POLICY “ROAD SHOW” • ACHDHR (Advisory Committee on Health Delivery and Human Resources) • POLLS

28. 5. Thoughts for CAO • ARTICULATE VALUE to efficiency and effectiveness of health system(s) • INFILTRATE and INTEGRATE!

29. Thoughts for CAO... • BUSINESS CASE – how can vision care contribute to better health outcomes, and efficiencies for the system(s) • Use the PUBLIC • Use all MEMBERS, all levels • POLITICS? (CMA; CCA)

30. Thoughts for CAO... • Seek PROJECTS WITH GOVERNMENTS – HC, HRSDC, DND • CHRONIC AND COMPLEX CARE • MOBILITY • HEALTH PROMOTION • NATIONAL HEALTH LITERACY GROUP

31. Thoughts for CAO... • PHAC • CIHI • Research Canada: An Alliance for Health Discovery • CHLNet/ILA (“Boundary Spanning Leadership”) • CCPH21 • NHLC - Present, and profile

32. Thoughts for CAO... • Meet with EDITORIAL BOARDS • PRODUCT RECOGNITION Program (Oakleys for DND? Olympics?) • WEBSITE

33. Thoughts for CAO Revisited... • ARTICULATE VALUE to efficiency and effectiveness of system • INFILTRATE and INTEGRATE!

34. THANK-YOU! Questions? Comments?

35. 17 York Street Ottawa, Ontario K1N 9J6 Tel: (613) 241-8005 Fax: (613) 241-5055 www.cha.ca Pamela C. Fralick Tel: (613) 241-8005, x202 E-mail: chapresident@cha.ca www.cha.ca