THE INTERIM FEDERAL HEALTH PROGRAM ( IFH ) Medical Services Branch CIC

1. THE INTERIM FEDERAL HEALTH PROGRAM ( IFH )Medical Services Branch CIC February 20, 2007 Joy Baldwin Manager IFH

2. Interim Federal Health Program • The objective of the IFHP is to provide eligible clients with access health services that will contribute to optimal health outcomes in a fair, equitable compassionate manner with the ultimate goal of successful integration in to Canadian society.

3. Interim Federal Health Program • IFH receives its mandate from an Order in Council 1957. • The program provides coverage for essential/emergency health care and medications to bridge the gap for its clients between their arrival in Canada until their access to provincial health care.

4. Internal Audit(Oct.2005) • Recommendations of the 2004 internal audit of the IFH control framework: • need to update IFH program authority • improve management framework and create succession plan • implement technological innovations • Enhance program analysis and policy capability

5. Changes to Governance Structure 2006 • Established governance structure within the IFH program • Creation of a Management and Accountability Committee within CIC • Central Policy Committee within CIC

6. Changes to Governance Structure 2006 • Placement of the program under the Program Management and Control Directorate linking operations more directly to senior management policy makers • Established management and accountability framework reporting to CIC’s Management and Accountability Committee • Full participation in the activities of the Federal Health Partnership sharing efforts, expertise and best practices and reducing duplication of efforts by the participating departments

7. Current Status • Expanding policy and operational capacity • Hiring a program specialists to expand research and analytical capacity and drive policy decisions responsive to the current needs and realities of our clients • Hiring of a program supervisor who will be key to establishing and maintaining an effective communication network to provide greater support to service providers, SPOs, NGOs and local CIC offices (including training)

8. Current Pressures (1) • Increasing complexity of health and psychosocial issues for incoming refugee populations • Challenges ( related to health and psycosocial needs) on resettlement and integration infrastructures and support systems are immense

9. Current Pressures (2) • Commitment to bring large protracted refugee groups from high risk environments to Canada, requiring enhanced protocols and post-arrival interventions in relatively short time frames.

10. Main Priority • Expand policy and research capacity to facilitate timely policy decisions that are fiscally responsible and respond to the current and expanding needs of clients with the ultimate goal of successful integration.

11. Program Priorities (1) • Strengthen international, national, provincial/territorial and local communication networks • Facilitate seamless health integration • Establish governance/accountability framework • Enhance program analysis and policy capability

12. Program Priorities (2) • Improve access to care. • Review and revise eligibility criteria • Conduct independent review of coverage and fee schedules • Develop and implement multi-faceted communication strategy (internally and externally)

13. Current and Ongoing (1) • Revising fee structures to provincial rates where possible • Ongoing efforts to remove barriers to care • e-mail IFH-program@cic.gc.ca • direct contact with reluctant providers • work with organizations and companies • enhanced training and support to providers • electronic billing for medical/pharmaceutical • develop training plan to improve provider buy-in • Preparing high level policy issues for elevation and decision

14. Current and Ongoing (2) • IFH now covering trafficked individuals for 120 day reflection period • Electronic adjudication of eligibility/pre-approvals creating a completely paperless file processing and storage system • On line billing/ invoicing/ payment for dental claims with other areas in the implementation phase

15. Consideration for Program Evolution (1) • post landing comprehensive health assessment (pilot with Karen Refugees) • pre-departure care for high risk populations (pilot- Africa, Karen movement) • more flexible coverage for interpreters • psychological and trauma care

16. Consideration for Program Evolution (2) • Coverage for prescribed OTCs • health prevention & promotion (Karen early PH) • dental restoration • expanded care for the elderly • health broker services (integration with primary care)

17. Strengthen and Build Partnerships • Work with Refugee branch to develop synergy with their refugee programs and ensure optimal health and psychosocial client outcomes • Enhance communication with primary care network and settlement community • Strengthen communication and develop partnerships with provincial health care systems where possible

18. Next Steps • Short term goals • improve communication of information • remove barriers to care • review and revise fee structures • Move needed policy decisions forward • establish and maintain consultative network to influence needed changes

19. How you can help! Discussion on main issues and possible solutions.