Government Relations Report Issue 48

Fall 2003 CSANews Issue 48  |  Posted date : Apr 25, 2007.Back to list

As you have read read from Ellen White's president's report, she and our executive director have just returned from a political tour of our provinces and territories, meeting with government representatives, cabinet ministers and premiers. We are very pleased with the outcome of our initiative and are quite certain that changes in our provinces' residency requirements are on the horizon as a result of our talks.

We garnered some valuable information from our discussions - including the fact that there is a national residency agreement (the Eligibility and Portability Agreement) across all jurisdictions (except Quebec), and that this is to protect the various provinces' health-care programs from misuse. It stems from people who live in one province, but want to seek perhaps better medical coverage in another. The criteria established and followed by all is that if someone is residing outside a particular territory/province (i.e. buys a house) not a day longer than six months, they become automatic residents of that new province. Thus, our problems with residency.

The following is a synopsis of our meetings to date. We will be travelling to New Brunswick in mid-September:

Ontario: I joined Ellen White for the meetings at Queen's Park in Ontario. Although it was during the SARS crisis, Health Minister Tony Clement took time out of a very hectic schedule to discuss our issues of concern. The minister shared the information that the government was launching a comprehensive program for evaluating and reviewing all health-related programs. He requested CSA's participation in the form of a brief that would be considered in their discussions.
Paul Jenkins, Tony Clement (Ontario Minister of Health & Long-term Care), Ellen White

Minister Clement also promised to address our concerns about prescription medication, regarding matching dates for time out of country (212 days rather than 200) and reimbursing for emergency out-of-country medication.

We also spent some time with Ontario's Minister Responsible for Seniors, the Honourable Carl DeFaria. Minister DeFaria expressed concern about Ontario's grades in the report card and offered advice on how to proceed with our initiatives. He has also expressed an interest in working with the CSA towards resolving the residency issue.

Prior to my arrival in Toronto, Ellen had the opportunity to speak with official Opposition Liberal leader Dalton McGuinty; deputy leader Sandra Pupatello; Liberal health critic Mike Brown; and policy analyst Karli Farrow. At this meeting, Mr. McGuinty not only gave his word, but also put into writing, his commitment to the principle of portability that Canadians should have health coverage outside of Canada, as well as when at home. They were also very interested in, and would like to follow up on the CSA's other report card recommendations.

Pic 2: Paul Jenkins, Tony Clement (Ontario Minister of Health & Long-term Care), Ellen White

Nova Scotia: Second vice-president, Jack Kiuru joined us for our Nova Scotia department of health meeting. We met with associate deputy minister Cheryl Doiron; chief financial officer Byron Rafuse, and Harold McCarthy, director of revenue recovery. They were very interested in our stand that Canadians who travel out of the country during the winter months actually end up saving the provinces money by living a healthy, illness-preventive lifestyle, as well as by not using many of the amenities their taxes fund.

Discussion took place about allowing absences of up to 30 days for Canadian travel, once the allotted time out of country has been reached. We were advised that the Nova Scotia ruling of "12 months out of Nova Scotia, only once in a lifetime" is being reviewed and that a change to once every five years is being considered.

Pic 3: Byron Rafuse (Chief Financial Officer), Cheryl Doiron (Associate Deputy Minister), Ellen White, Harold McCarthy (Director of Revenue Recovery) & Jack Kiuru

Prince Edward Island: Meetings in my home province included talks with the director of medical services, provincial medical director Don Ling; manager of physician resources and medical services Johanne Irwin; and manager of hospital services, acute and continuing care division Joyce Thompson. A planned, very short meeting with health minister Jamie Ballem was missed due to an extended cabinet meeting.

When discussing portability, Dr. Ling commented that the consensus was that the province "owed more to those who are here for the winter." I found this strange, as we had just heard P.E.I. Premier Binns speak in Toronto, and his words were, "we should not be penalized by where we live," referring to the Islanders in comparison to other Canadians.
I must report that we actually received very little assurance from Dr. Ling that he would recommend any improvements or changes for travelling Canadians from Prince Edward Island. We have since received a phone call from Premier Binn's office, requesting a meeting.

Pic 4: Paul Jenkins, Ellen White, Johanne Irwin (Physician Resources Manager, Medical Services), Joyce Thompson (Hospital Services Manager, Acute & Continuing Care Division), Don Ling (Director, Medical Services)

Nunavut: Nunavut proved to be enlightening on a number of fronts. In addition to our presentation to Premier Okalik acknowledging Nunavut's high standing in our report card, we confirmed that there are large numbers of travellers leaving Nunavut during the long winter months. Premier Okalik is looking forward to continuing a positive relationship with the CSA.

Newfoundland and Labrador: In Newfoundland and Labrador, we were honoured to meet with Premier Grimes, Minister of Intergovernmental Affairs and government House leader Tom Lush, and deputy minister of intergovernmental affairs Andrew Noseworthy. The welcome was typical Newfoundland – warm and friendly. The premier was very positive and agreed that residency requirements were unfair, and that a Canadian was a Canadian regardless of his or her travels.

The Election Act within the province has recently changed and the province will contact those who are out of province. A constituent can now arrange to vote prior to the election date's being announced.

Pic 5: Tom Lush (Deputy Minister of Intergovernmental Affairs), Paul Jenkins, Ellen White, Premier Grimes

Quebec: Our visit to Quebec was the first of two – we hope to be returning within the coming months for additional meetings. This time around, Ellen and CSA Quebec director Roland Belanger met with chief electoral officer Marcel Blancet and information officer Farrah Bérubé. In our opinion, the mark given in our report card must be upgraded since Quebec's election office has developed an excellent system to ensure that the greatest possible number of voters go to the polls.

In order to vote in any election, all one must do is register (with a forwarding foreign address) with the elections office prior to leaving for an extended length of time. When an election is called, the elections office sends a package via courier to absentee voters.

We also met with Mr. Claude Longpré, political attaché to the minister of intergovernmental affairs. As his party was new to power, they had no background information on the CSA and Ellen White provided a brief history of our "discussions" with the province.

We are very excited about this change. We are now dealing with a new government and the CSA hopes that dialogue with Premier Charest will lead to positive results for travellers.

Pic 6: Marcel Blanchet (Cheif Electorial Officer), Farrah Bérubé (Agente d'information), Ellen White, Roland Belanger

Pic 7: Roland Belanger, Ellen White, Claude Longpré (Attache Politique)

Alberta: There were a number of meetings in Alberta, the first with Mr. Bruce Tait, director of social, fiscal and constitutional policy. Mr. Tait agreed that our portability issue with Alberta centres on the interpretation of the Canada Health Act (CHA), but also stated that in "a world of short resources," out of country is not a great concern. Ellen White explained our position regarding Mr. Romanow's suggestion - Mr. Tait noted that portability is part of the CHA and Alberta believes that it "has to support the principles."

Ms. Janet Skinner, assistant deputy minister of health and wellness discussed the fact that the residency policies changed in 2000.

The requirement is that Alberta residents who want to maintain their health-care insurance coverage, while travelling outside of Canada for more than six consecutive months, should contact Alberta Health and Wellness to request an extension of coverage up to a maximum of 24 consecutive months. It was suggested that members call (780) 427-1432 (general call centre). We asked that this be clearly defined in a policy letter, which has since been done. Ms. Skinner noted that some travellers contact the ministry to ask for their coverage to be cancelled while they are away, in a misguided belief that they will not need to pay their premiums. This is not the case, and the result could be a loss of their health coverage.
Alberta's deputy chief electoral officer Bill Sage, and director of elections operations Lori McKee-Jeske noted that in the last provincial election, 11,000 ballots were cast out of the county, and that requests for ballots are made in a variety of ways. Presently, there is discussion about having a fixed election date, similar to British Columbia's system.

Saskatchewan: In Saskatchewan, provincial director Harley Sundbo joined Ellen White for a meeting with the premier's chief of staff Deb McDonald. Later in the day, meetings were held with associate executive director of medical services branch, Bob Firnesz; assistant director of health registration and vital statistics, Pat Cambridge; acting director of pharmaceutical services, drug plan & extended benefits, Margaret Baker; Crown counsel, Department of Justice, Leanne Lang, and director of intergovernmental and Aboriginal health policy, policy and planning, Kimberly Kratzig.

Ms. McDonald informed the CSA delegation that Saskatchewan does not have the ability to spend money transferred by the federal government, as there are always strings attached. When asked if the Saskatchewan government supported Mr. Romanow's stance on portability, Ms. McDonald replied that they support his report and did not "cherry pick" from it.
The health meetings proved quite interesting. It appears that there is no support for Mr. Romanow's portability views in this jurisdiction. Ellen White has suggested that Saskatchewan's marks for residency requirements will go up, as there is provision for temporary absence for up to one year. Once again, it was stressed that travellers absent for more than three months should check in with the province's health ministry. CSA requests a policy letter to clarify this for travellers.

Manitoba: In Manitoba, we met with Ms. Jeannine Ste. Marie, manager, provincial drug programs, and Ms. Gail Keeley, senior pharmacist, provincial drug programs. Manitoba has a universal system, with a one-time enrolment. It is geared to income and no one spends more than 3.31 per cent of his or her income on medication. Manitoba now allows medication supplies for out-of-country for up to six months.

Ms. Ste. Marie and Ms. Keeley were very complimentary about the work which CSA Manitoba director, Malcolm Joyce has done on behalf of his province's residents. As it was shortly after the Manitoba election, further meetings in September are being arranged.

Northwest Territories: CSA President Ellen White presented a plaque of appreciation to deputy minister Dave Murray and director of territorial services for health and social services, Rick Trimp, once again celebrating Northwest Territories' commitment to the rights of Canadian travellers. We received an exceptionally warm welcome and enjoyed an extremely proactive meeting.

British Columbia: After our meeting with chief electoral officer Harry Neufeld, we believe that their report card mark should be raised immediately. Unlike any other jurisdiction, British Columbia has a fixed election date, the next being May 7, 2005.
B.C. also has "recall petitions," whereby a voter must be present to sign or not sign support of an elected official. If a recall petition passes with a majority of votes opposed to the elected official (meaning that the constituents are not pleased with the current official's representation), an election must be held to replace that person. British Columbia is the only jurisdiction in the Commonwealth to have this program. Again, it was put forth that travellers should be proactive when it comes to their right to vote. An interesting note: those 55 and older form the largest participating voting body.

After many attempts, we were able to secure meetings with British Columbia's Minister of Health, The Honourable Colin Hansen, and Minister of Intergovernmental Relations, The Honourable Greg Halsey-Brandt. B.C. director Peter Sloggett joined us in Vancouver for the intergovernmental relations meeting.

In the past, the majority of those retiring moved south - this trend is changing, as people are developing roots and want to be with their families. Snowbirds who are residents of NWT and are out of the territory beyond six months must be proactive and let the ministry know.

Minister Halsey-Brandt was interested in snowbird matters and we outlined some of the issues/concerns our members in British Columbia have with portability, residency and medications.
At a later meeting, Minister Hansen stated that the $75 'facilities' cost did not include physician fees, which the province does cover at the same level as is paid in B.C.

Our discussion regarding residency requirements with Minister Hansen will perhaps clear up confusion for many B.C. residents. The minister stated that one can be out of country for six months and may then leave the province for short trips in Canada. However, he was adamant that B.C. residents must get permission by advising the ministry that they are leaving the province. Ellen White has requested a letter outlining this policy.

Minister Hansen also attempted to explain why B.C. snowbirds cannot access prescriptions equal to the time allowed out of province: there is concern that residents will not see their doctors as often, or will use unnecessary drugs. This means that many residents must either get a prescription renewal while outside of the country if out beyond the 100 days, or come home. Despite our arguments, there appeared to be no will to change this policy at present.

Yukon: The CSA met with Yukon's Minister of Health and Social Services, The Honourable Peter Jenkins, to present him with a plaque celebrating Yukon's commitment to the rights of Canadian travellers.
The Yukon has no charge or user fee like some provinces do for health care. Although regulation states that travellers may access a three-month supply of medication, it appears that they can, in fact, access a six-month supply.

As a footnote, in addition to our meetings in Toronto, we also met with acting U.S. Consulate General Phillip Hoffman; U.S. Trade Consul, Patrick Santillo and Consul Hugh Williams Jr. Topics of discussion ranged from the resolution of the INS issue, to how best to disseminate information to Canadian tourists regarding finding "deals" in the United States. Mr. Williams also strongly suggested that the president of the CSA meet with officials who are responsible at the various points of entry into the US.