Public Service Alliance of Canada BC

Here are some Q&A’s regarding upcoming changes at Health Canada.

Introduction

A full evaluation of the Public Service Health Program (PSHP) was completed in 2007/08. In light of this review, the Treasury Board Secretariat and Health Canada have agreed that the occupational health service delivery support that Health Canada provides to the federal public service through the PSHP must be adapted to ensure future sustainability for the program.

In order to do this, beginning in 2009, the PSHP is transitioning to a new program model known as the Occupational Health Medical Services model (OHMS). This transition will ensure that deputy heads can rely on Health Canada to provide occupational health support in areas that are best delivered through an internal common service. On the other hand, those services which are available elsewhere and can be delivered at the departmental level will no longer be provided by the PSHP.

While the PSHP will cease to provide some of its current services, the transition to the OHMS model will involve strengthening other services. This will improve the program’s focus on the provision of high quality and timely medical services that respond to the unique occupational health needs of the federal public service. The overriding objective of the PSHP remains excellence in service delivery.

QUESTIONS AND ANSWERS

Q1. What are the reasons behind the proposed changes?

• Several years ago, Health Canada (HC) and Treasury Board (TB) agreed that the PSHP needed to be reviewed and renewed in order to be able to respond to increasingly complex occupational health needs of the federal public service and to address new accountability requirements related to occupational health within federal departments.

• The program has been under-funded for several years. HC has provided deficit financing to close the gap between the approved PSHP budget and the actual cost of program delivery, which has been increasing. This undermined the program’s integrity and required a response.

• Additionally, the adjustments that will be implemented support the Prime Minister’s announcement in early February that Treasury Board delegate all HR responsibilities to deputy heads, including occupational health and safety.

Q2. Was this done as a result of Strategic Review?

• The PSHP review and renewal process predated Strategic Review at Health Canada. While the new program development was informed by Strategic Review, the changes are not as a result of Strategic Review.

Q3. How was the OHMS model developed?

• In 2007/08, Health Canada contracted Mercer (Canada) Limited to conduct an assessment of the performance of the PSHP. They did an analysis of program management and accountability, service delivery, a survey of clients’ needs and occupational health purchasing practices, a market analysis, and comparative research on the practices of other large employers. They were also asked to undertake a gap and a risk analysis and develop options for the renewal of the program. In considering options, they were asked to consider both existing service lines and services purchased by clients and to look at both existing and alternative delivery mechanisms as well as full and partial cost recovery. The results of this study validated previous study results and have been instrumental in the development of the OHMS model.

• In addition to these studies, PSHP staff and managers across the country had the opportunity to provide feedback on service scenarios. This input has helped us to refine our knowledge of the program and model development.

• There were some guiding principles that we used in the development of the model, namely:

o Risks had been identified and analysed

o Consistency with regulatory requirements of the Canada Labour Code and the TB OHS policy

o Consistency with trend towards increased HR accountabilities assigned to Deputy Heads in the spirit of PSMA, the CLC and TB OHS Policy

o Consistency with financial accountability and due diligence of Health Canada as a service provider

o Recognizing client departments’ ability to choose different mechanisms to meet their OH responsibilities (e.g., private sector providers)

o Service delivery limitation based on the degree of complexity, the demand, and our ability to meet these demands within the resources available.

Q4. What are the key features of the OHMS model?

• The OHMS Model will focus on the provision of high quality and timely medical services in support of client departments’ unique occupational health requirements where alternatives are insufficient or unavailable.

• The full gamut of health evaluations services will be maintained. These include: preplacements, pre-posting, cross-posting, return from-posting, periodic, fitness-to-work evaluations and the development and maintenance of the Occupational Health Assessment Guide (OHAG).

• The PSHP will continue to provide existing communicable disease services, with increased efficiency and timeliness.

• The PSHP will continue to provide health education, promotion and training as well as research on emerging issues, but only as it relates to the OHMS model service lines.

Q5. Are there other changes that will happen?

• In order to further reduce our costs, we have had to take some decisions to share costs with clients in certain areas. We will be providing you with more information on how this will work in advance of the implementation date.

• Should clients require the addition of new job categories or other changes to the OHAG, where there will be costs to the PSHP to deliver the services, they will need to ensure additional resources are provided to the PSHP to cover the resulting cost increases associated with the delivery of these services.

• Clients will be required to cover the cost of referrals to external specialists that may be required for Fitness to Work Evaluations (FTWEs).

• Clients will be required to cover the cost of consumable medical supplies needed in the provision of immunizations (e.g. vaccines, syringes, etc).

• Clients will also be required to cover the costs associated with travel to provide services to clients located outside of the greater metropolitan areas.

Q6. Which services are no longer going to be provided once the transition to the OHMS service model is completed?

• PSHP will cease all activities under the Ergonomics service line effective October 31st, 2009.

• Effective November 1, 2009, the PSHP will begin reducing Workplace Investigation services with an aim to end all workplace field investigations and related services by March 31, 2010. Workplace investigation service support will be strictly limited to a strategic industrial hygiene advice capacity in support of medical services delivery and development and maintenance of the OHAG.

Q7. What about Superannuation services? Will you continue to provide these services?

• With respect to PSHP’s Superannuation services, including the review and assessment of applications for Medical Retirement and Buy Back of Services, a separate initiative is underway to secure additional funding to maintain existing service levels. This will have no effect on delivery.

Q8. How have you informed my department?

• Your Deputy Minister has received a letter jointly signed by Health Canada’s and Treasury Board’s Deputy Minister and Assistant Deputy Minister advising them of the changes. With that letter, we have also provided a Fact Sheet which details your department’s usage of PSHP services to assist you in understanding the impact of this change.

• In addition, the ADM responsible for OH in your department has received a letter which provided some additional details.

• We will also be meeting with key clients at the corporate level to further explain the changes and discuss transition strategies. We want to ensure that you understand the situation as well as your responsibilities in addressing the gaps and help you with the transition.

• Our offices in the regions will be meeting with clients locally to discuss program changes.

• We will also meet regularly during the transition period with departmental OHS Coordinators in Ottawa to discuss the program changes.

• Our staff will continue to work with you until the service line is discontinued and will assist you as best they can in identifying solutions to meet you occupational health needs.

Q9. Why did you choose to be medically focussed and to discontinue ergonomics and workplace investigations?

• The Mercer study recommended that the ergonomics service line be discontinued. Additionally as we realized our funding would not support the remaining service lines and some difficult decisions had to be made.

• We decided to focus our service offerings in the areas where we could provide the best services within the funding base available.

• Feedback we received from regional management, staff and clients recommended a sharper focus on doing what we can do well, rather than spreading ourselves too thin across too many activities.

Q10. For Ergonomics, what happens between now and October 31, 2009?

• The PSHP will continue to accept appointments for individual ergonomic assessments if the service can be delivered by August 31st. In some regions, this will mean that bookings will continue further into the summer. In other regions, all bookings will cease as backlogs mean that services cannot be provided before August 31, 2009.

• Requests for individual ergonomic assessments already received will be handled as staff are able to undertake them. In some regions, the backlog is not great and will be cleared quickly following the August 31st cessation date. In other regions, the backlog is significant and could take several months to clear. We will be looking at strategies to help regions with large backlogs to clear them quickly and efficiently.

• During the transition period, we encourage you to establish or enhance your own internal ergonomics program and we are prepared to assist you in doing so. This service will be made available to clients until October 31, 2009 so we would encourage you to contact our offices as early as possible to make arrangements for the necessary interventions so this work can be scheduled with our staff.

• After October 31, 2009, no further ergonomic services will be provided.

Q11. Where are we supposed to get ergonomic services after you discontinue?

• The PSHP is not in a position to recommend any providers as this would be in conflict with the Treasury Board and PWGSC policies for procurement, contracting and acquisitions as well as the Values and Ethics Code for the Public Service.

• We have prepared a guidance document which outlines what governing bodies are involved in ergonomic services in Canada and offers some suggestions as to where you may go to access the services of competent service providers. This document is available from our regional offices and will be provided to your corporate OSH coordinators.

• In addition, you should take advantage of our services between now and October 31, 2009 to consult with our professionals on setting up your own Internal Ergonomics Program. We would encourage you to contact our offices as early as possible to discuss as there may be significant demand for these services during the phase-out period.

Q12. For Workplace Investigations, what happens between now and March 31, 2010?

• The PSHP will continue to provide workplace investigation field services until October 31, 2009.

• After October 31, 2009, the focus will be on clearing up any backlog and continuing to work with clients in providing advice and consultation only. (no further field investigations) We will continue to work with clients to assist them in making the transition.

Q13. Where are we supposed to get workplace investigations services after you discontinue?

• The PSHP is not in a position to recommend any providers as this would be in conflict with the Treasury Board and PWGSC policies for procurement, contracting and acquisitions as well as the Values and Ethics Code for the Public Service.

• We have prepared a guidance document which outlines what the governing bodies for workplace investigation services in Canada and offers some suggestions as to where you may go to access the services of competent service providers. This document is available from our regional offices and will be provided to your corporate OSH coordinators.

Q14. We have heard that you will be retaining Industrial Hygiene support in your new model. Why can we not access these services?

• You will still be able to access our services for advice and guidance on workplace issues up to March 31, 2010. After that date, the remaining industrial hygiene capacity in the program will focus on supporting our medical professionals in the delivery of the OHMS model. One example of what they will be doing is reviewing the risk assessments prepared by departments for consideration for changes to the OHAG. Their function will be internally focussed, not external.

Q15. What happens to the staff who currently deliver these services?

• We are taking all steps to minimize the impact on our staff. Some staff will be shifted over to work on the remaining service lines (Health Evaluations and Communicable Diseases). Our goal is to place all affected employees over the course of the 1-2 year HR transition period within Health Canada. Should this not prove to be possible, we will be assisting our staff to find placements outside this department.

Q16. What can I do if I have more questions about these changes?

• We would encourage you to talk to our regional offices to better understand the changes, to understand how they impact you, and to explore transition strategies.

• Please feel free to send any questions, comments or concerns you may have about the program to PSHP_PSFF@hc-sc.gc.ca.

• Bring your concerns on delivery of these services to the corporate section responsible for occupational health in your department. They have been notified of these changes and should be able to provide guidance to you as to how your department will
approach this change.