The business plan for the three years commencing April 1, 2006 was prepared under my direction in accordance with the Government Accountability Act and the government's accounting policies. All of the government's policy decisions as of February 23, 2006 with material economic or fiscal implications of which I am aware have been considered in preparing the business plan.

The Ministry's priorities outlined in the business plan were developed in the context of the government's business and fiscal plans. I am committed to achieving the planned results laid out in this business plan.

[Original Signed]

Iris Evans, Minister of Health and Wellness
March 1, 2006

THE MINISTRY

Albertans are healthy and live, work and play in a healthy environment.

Provide leadership and work collaboratively with partners to help Albertans be healthy and respond to opportunities and change.

Support individuals, families and service providers in making the best decisions about their health.

The Health and Wellness business plan is aligned with and supports the "Making Alberta the Best Place to Live, Work and Visit," strategic opportunity of the Government of Alberta 20-year strategic plan. The Health and Wellness business plan links to the government business plan through:

• Albertans will be healthy (goal 5).
• Alberta will have a supportive and sustainable infrastructure that promotes growth and enhances quality of life (goal 14).

The Government of Alberta regards the health and well being of Albertans as the most important resource for the future. The Alberta government is committed to working towards providing Albertans with the best and most responsive public health system in Canada. Alberta is embarking on a Third Way in health care delivery to improve quality and access and to increase choice. This made-in-Alberta approach to health care renewal focuses on evolving our health system by unleashing innovation, challenging the status quo and charting a new course. The Third Way is an evolving process with initiatives and innovations created at local, regional and provincial levels and by all service providers.

On July 12, 2005, the government unveiled a package of thirteen renewal initiatives called "Getting on with better health care". These initiatives include innovations in priority areas such as access, continuing care, wellness, mental health, primary care, children's health, pharmaceuticals, electronic health records and rural health.

Alberta is embarking on a Third Way in health care delivery to improve quality and access and to increase choice. In fostering new ideas and approaches, we are encouraging everyone to look for practical ways to make services more efficient, responsive and accessible to those who need them. The following actions identify innovative new approaches for the delivery of health services:

Health policy – We need an overall health policy that focuses on wellness and personal responsibility, defines what services are included in the publicly-funded health system, guides our decisions and sets clear priorities.

Access and efficiency – While people get immediate care when there is an emergency, this may not be the case for non-emergency situations. Work to streamline the processes, get rid of bottlenecks and speed up access to important health services is underway.

Wellness and injury prevention – Encourage Albertans to take greater personal responsibility for their own health and wellness. By choosing healthier lifestyles, Albertans will be able to prevent or delay the onset of chronic conditions. Healthy eating and active living, combined with decisions that reduce personal health risks, will improve quality of life and long-term health outcomes and decrease demands on the health system. Immunization is one of the most cost effective medical interventions to prevent diseases. Strategies to improve immunization rates in Alberta are necessary to eliminate/reduce vaccine preventable diseases in our province.

Children's health – It makes good sense to make children's health a top priority. We need to take action to improve the health of all children and especially those who are at risk – whether those risks involve violence in their communities, homes or schools, exposure to drugs and alcohol, unhealthy lifestyles, or not being immunized against common childhood diseases. Specific action will be taken to respond to the risks and harm associated with crystal methamphetamine abuse.

Access to mental health services – One in five Albertans will be affected by mental illness during their lifetimes. The nine regional health authorities are developing their own plans based on the Provincial Mental Health Plan. Commencing with the 2006-09 planning and reporting cycle, health regions will provide specific information about mental health performance and outcomes.

Electronic Health Record–Alberta Netcare – The Alberta Netcare system is absolutely essential for moving ahead on a whole range of initiatives in the health system that will result in better care, better decisions and safer health services. For Albertans, it means an end to repeat tests and the security that when they have a health problem, the people who are treating them have access to a complete picture of their health.

Primary health care – A comprehensive, coordinated approach to primary health care that is available 24 hours a day, seven days a week. Multi-disciplinary team delivery ensures Albertans get the right provider and the right services at the right time.

Legislation and regulations – Legislation and regulation changes need to be made to expand choices for Albertans and remove barriers that stand in the way of further innovation.

Prescription drug costs and coverage – Drug costs are the fastest growing part of the health care budget. We need to look at how we are going to pay the bill for drugs now and in the future. At the same time, current government drug plans only cover about 18 per cent of Albertans including seniors, children and people with lower incomes. Most Albertans get their prescription drugs covered through private insurance plans, but about 27 per cent of Albertans have no coverage at all.

Continuing care quality – The emphasis for continuing care, both long-term care and home care, will be on quality of service. Albertans expect their parents and grandparents will be well cared for in places where they are respected and treated with dignity. In the longer term we also need to look at new approaches for paying for long-term care including insurance programs or savings plans where people could invest now.

Health care providers – The provision of health care requires a well-trained and well-motivated workforce of an appropriate size and mix. Compensation of the health workforce (including physicians) accounts for approximately 70 per cent of health system expenditures. Consequently, health workforce strategic and operational planning is critically important to the long-term sustainability of the Alberta health care system.

Rural communities – Access to health care is a critical issue in rural communities and they face special challenges in being able to provide the range of health care services people need and expect. The provincial government's Rural Development Strategy identifies health care as one of the fundamental pillars that must be addressed in order to preserve and sustain rural communities.

Supplementary health insurance – Conduct research and consult with experts on insurance programs for continuing care, prescription drugs and other non-emergency health services. Supplementary health insurance would not be required to cover any medical emergencies or medically necessary health services.

Improving Alberta’s Health System – The Third Way – Enhance the sustainability of the health system now and in the future by strengthening policy integration and collaboration across ministries. The Ministry will lead this initiative, which is one of the eight Top Priorities of the three-year government business plan. Actions taken will include:

• Child and youth wellness strategy
• Common pharmaceutical framework
• Continuing care strategy
• Insurance program for continuing care, prescription drugs and other non-emergency health services.

Albertans want to know that their health system is prepared and able to protect them from risks to their health. Recent events such as the outbreak of avian influenza, SARS and West Nile virus as well as a potential pandemic have reinforced the importance of strong public health programs. Albertans are partners in this effort. Key strategies for managing public health risks include:

Protect Albertans against communicable diseases – Strengthen and restructure system capacity to respond to public health issues and risks. Create a communications partnership with other ministries, municipalities, agencies, associations (e.g., Alberta Urban Municipalities Association, Alberta Association of Municipal Districts and Counties) and other stakeholders to ensure Albertans get timely information on how to protect themselves against all communicable diseases in case of a catastrophic event such as pandemic influenza.

Protect Albertans from environmental health risks – Protect Albertans from health risks in the environment through education, regulatory enforcement and partnership with other agencies.

The health and wellness of Albertans is influenced by genetic factors, early childhood development, education, employment status, the environment and personal decisions about lifestyle behaviours. The Ministry provides health information to Albertans to promote healthy lifestyle and quality of life choices.

1.1 Support Albertans in making healthy lifestyle choices through information services like healthyalberta.com.

1.2 Collaborate with community stakeholders to strengthen the ability of individuals and communities to increase healthy behaviours and reduce the risk of disease, illness and injury.

1.3 Provide health and lifestyle information to help people make healthy choices to reduce the risk of disease and injury (e.g., Fetal Alcohol Spectrum Disorder, obesity, sexually transmitted infections, HIV).

1.4 Ensure that addiction information, prevention and treatment services are available province-wide.

1.5 Work with other ministries to target strategic health and wellness initiatives that address the health needs of children, youth, seniors, Aboriginal communities and Albertans with disabilities or who are disadvantaged.

The Ministry monitors the health system and provides leadership and planning for prevention services delivered through health authorities and other partners. As public health issues such as avian influenza gain attention worldwide, Albertans need to know their health system is ready and able to protect them. The Ministry provides support and leadership in the development of the overall provincial response and emergency plans to deal with outbreaks and health threats. These services help to protect Albertans from disease and injury.

2.1 Reduce suicide and the risk of serious injury through education and targeted interventions in collaboration with other agencies. Work with AADAC, Children's Services, and Solicitor General and Public Security to reduce the number of youth suicides.

2.2 Protect Albertans against communicable diseases by strengthening the health system's capacity to prevent, be prepared for and respond to public health risks such as vaccine-preventable diseases, emerging threats like avian influenza and increases in sexually transmitted infections.

2.3 Protect Albertans from environmental health risks transmitted via air, water, food and physical environments through education, environmental and air quality monitoring, regulatory compliance and enforcement in partnership with other ministries.

2.4 Develop networks and initiatives that improve access to disease screening and prevention services such as the Alberta Stroke Network.

2.5 Work with other ministries on the Water for Life Strategy to ensure safe and secure drinking water for Albertans.

2.6 Develop a provincial immunization strategy that would lead to improved immunization rates among Albertans.

2.7 Conduct health surveillance; assess and report on health trends in selected health priority areas (e.g., a reproductive health report, a West Nile Virus report, an updated children's health status report, and an injury report).

2.8 Work with other ministries to reduce the transmission of infection in the provision of health care and other community services (e.g., day cares).

2.9 Utilize funding from the Alberta Cancer Prevention Legacy Fund to put Alberta at the forefront of cancer prevention, screening and research.

Albertans expect health services will be accessible where and when they are needed. Working with health authorities and service providers, federal and provincial governments, Health and Wellness sets access standards for the health system. Improved access includes waiting time and geographic access standards and options in health services. These standards and their targets are as interconnected as the health system itself, and each target affects other health services.

3.1 Provide for continuing care services that allow Albertans to "age-in-place" in their homes and communities:

• work with regions to coordinate access to continuing care services for facility living, supportive living and home living;
• consolidate and modernize continuing care policy and regulations;
• collaborate with the Ministry of Seniors and Community Supports to address barriers/access to continuum of care and encourage innovation;
• expand community-based and home care services to enable individuals to remain in their communities as long as possible; and
• develop a new approach to paying for long-term care.

3.2 Find innovative and culturally appropriate ways to improve access to health services for all Albertans, especially populations who have not taken advantage of health services in the past.

3.3 Work with the Alberta Mental Health Board, regional health authorities and other partners to support their community-based implementation of the Provincial Mental Health Plan.

3.4 Continue to launch pilot projects to remove inefficiencies and speed up access to prostate cancer care, children's mental health and cataract surgery.

3.5 Begin implementation of Rural Development Strategy initiatives focused on health care in rural communities.

3.6 Improve Albertans' access to primary health care by changing how these services are organized, funded and delivered (e.g., Primary Care Networks, Academic and Non-Academic Alternate Relationship Plans, Telehealth, new models for delivery of primary health care services).

3.7 In partnership with health authorities and other ministries, develop and implement long-term capital plans to ensure Albertans have access to appropriate facilities and services.

Provide strong leadership to ensure that a qualified and integrated health workforce meets the current and future health care needs of Albertans.

4.1 Collaborate with health system stakeholders to support the development and coordination of health workforce plans (e.g., Provincial Comprehensive Health Workforce Plan, regional health authority workforce plans, physician resource plans, nursing workforce strategy, development of Health Workforce Information Network).

4.2 Work with key stakeholders on initiatives to provide education and training programs to develop the needed health workforce (e.g., continue implementation and ongoing evaluation of the Health Care Aide Curriculum; provide placements for community medicine residents and field surveillance officers from the Public Health Agency of Canada).

4.3 Provide leadership to key stakeholders on initiatives to recruit, retain and appropriately compensate the needed health workforce (e.g., Rural Physician Action Plan, academic and non-academic Alternate Relationship Plans, Physician On-call programs, Provincial Nominee Program).

4.4 Work with regional health authorities, professional organizations and through the Tri-lateral Master Agreement structure to improve health care through innovations in service delivery and compensation with an emphasis on the development of multidisciplinary teams and incentives that enable health care practitioners to work collaboratively (e.g., Telehealth, academic and non-academic Alternate Relationship Plans, Primary Care Networks, Health Professions Act).

4.5 Promote effective and efficient utilization of the health workforce by encouraging the development of competency profiles across professions and interdisciplinary understanding of scopes of practice for care providers (e.g., Alberta International Medical Graduate program, increased use of nurse practitioners, Provincial Nominee Program).

4.6 Develop and implement regulations for health care providers under the Health Professions Act to enable health care practitioners to work to their full scopes of practice.

4.7 Increase rural access to health care practitioners and multidisciplinary teams (e.g., Rural Physician Action Plan, Telehealth, Primary Care Networks, Rural On-Call program, Rural Locum Program).

Albertans expect the best possible care and outcomes when they use the health system. As part of its leadership and assurance role, the Ministry established a quality framework including six dimensions of quality health services: acceptability, appropriateness, effectiveness, efficiency, accessibility and safety. The Ministry continually develops and updates standards, monitors compliance with standards to ensure the quality of programs and services, and develops new initiatives in response to technological advances, demographic changes and other factors.

5.1 Help Albertans with chronic health conditions (e.g., cancer, diabetes) maintain optimum health through appropriately managed and coordinated care, including paid and voluntary support systems and networks.

5.2 Improve quality of continuing care services by:

• enhancing assessment and case management to help clients to navigate through the health system;
• improving access to long-term care and home care services;
• addressing human resource issues by increasing the supply and training of personal care aides;
• implementing new standards for long-term care centres and continuing care services; and
• implementing, measuring and enforcing compliance with continuing care standards.

5.3 Work with health authorities to avoid and minimize risks or unintended results in providing health services by promoting quality standards for health services, such as patient safety and infection prevention and control (e.g., handwashing).

5.4 Strengthen the health system's capacity to define, report, monitor and prevent hospital¹ or community acquired infections, adverse events and medical errors.

5.5 Use information from the Health Quality Council of Alberta, including patient/client feedback, to assist in improving performance of Alberta's health system.

5.6 Initiate public reporting of outcome indicators for the key life-saving interventions of cardiac revascularization, kidney dialysis and transplants.

5.7 Review recommendations of the Ambulance Governance Advisory Council, including results of the Discovery Region pilot projects, and develop and execute an appropriate implementation strategy.

¹ Infections that are acquired while a patient is in hospital are referred to as nosocomial infections.

Alberta's complex health system is challenged by continuous change, rising costs, steady growth and increased public expectations. Health system innovation can only be achieved in collaboration with stakeholders and the Alberta public, through an effective coordination of efforts and clear, timely communication.

6.1 Continue to enhance and clarify the accountability relationships within the health system as public expectations evolve (e.g., Tri-lateral Master Agreement, health authority health plans, long-term care and surgical services contracts).

6.2 Implement a policy framework in collaboration with health authorities and professional organizations and continue to develop a health service plan, a provincial public health strategic plan, and a provincial research strategy.

6.3 Continue to lead, develop and enhance policies and frameworks that address data security, access, standards and quality requirements.

6.4 Work with key partners and stakeholders to enable Alberta's interests to be forefront in collaborative federal-provincial initiatives.

6.5 Prepare a discussion document on how private supplementary health insurance may affect continuing care, prescription drugs and other non-emergency health services.

6.6 Contribute to initiatives which strengthen collaboration, integration and coordination across ministries to enhance the sustainability of the public health system and ensure optimum strategic investment.

6.7 Collect and publish health system cost information. 6.8 Create new expert sub-committees to the Province Wide Services Working Group, consisting of clinicians and program managers, to advise on appropriate volumes, patient outcomes and accessibility for key life saving interventions.

6.9 Work with regional health authorities and other partners to strengthen the overall public health capacity in the province.

Innovation

6.10 Continue to implement health information technology to give clinicians drug, laboratory and diagnostic imaging data so they can provide quality patient care.

6.11 Change the majority of Alberta's diagnostic imaging services and equipment to filmless technologies to enable earlier diagnosis and reduce unnecessary duplication of diagnostic imaging procedures.

6.12 Implement the following systems:

• electronic systems within regions and physicians' offices to provide patient information to physicians at the point-of-care (e.g., computer access to a patient’s file from each treatment room);
• electronic tracking and referral and patient tracking systems to streamline access to selected specialty services; and
• improve system access and security to minimize fraud and better identify eligible health service recipients.

6.13 Provide leadership on federal/provincial/territorial work to manage the growing cost of pharmaceuticals including the protection of Albertans from catastrophic drug costs.

6.14 Introduce a new Health Care Assurance Act.

6.15 Enhance processes to decide whether to publicly fund new health services and technologies.

ALBERTA ALCOHOL AND DRUG ABUSE COMMISSION (AADAC)
Business Plan 2006-09

AADAC is an agency of the Government of Alberta reporting to the Minister of Health and Wellness. The Commission is governed by a Board of up to 12 members appointed by the Lieutenant Governor in Council. The Chair is a Member of the Legislative Assembly. The Commission Board provides policy direction for AADAC programs and services.

A healthy society that is free from the harmful effects of alcohol, other drugs and gambling.

Making a difference in people's lives by assisting Albertans to achieve freedom from the harmful effects of alcohol, other drugs and gambling.

AADAC is directly linked to government as part of the Ministry of Health and Wellness and is referenced in its Business Plan:

Goal 1: Albertans make choices for healthier lifestyles.
Strategy 1.4: Ensure that addiction information, prevention and treatment services are available province-wide.

One of the strategic opportunities of the Government of Alberta's 20-year strategic plan, Today's Opportunities, Tomorrow's Promise, is making Alberta the best place to live, work and visit. AADAC contributes to this vision by delivering responsive and affordable programs and services that promote healthy living. Through review of external and internal challenges, and in addition to AADAC's core activities, the Commission has identified the following strategic priorities for 2006-09.

1. Ensure the ongoing sustainability of addiction services across the province.
2. Continue to emphasize youth programs, and services for women and families.
3. Maintain research and information services to support prevention and treatment programming.
4. Provide focused programming for tobacco reduction and problem gambling in Alberta.
5. Continue to support employee wellness initiatives.

AADAC provides Albertans with current and accurate information on alcohol, other drugs and gambling. Information management and dissemination creates greater awareness of addiction issues and AADAC services, and it is required to support the development and delivery of prevention and treatment programming. Information and resource materials are available through AADAC offices and clinics, and are accessible on the AADAC web site at www.aadac.com.

• Develop and distribute evidence-based addiction information and resource materials to Albertans.
• Promote awareness of AADAC services.
• Conduct policy analysis to inform decision-making.
• Undertake research and evaluation to support delivery of addiction programs and services in Alberta.
• Maintain client information and performance measurement systems to support operations, business planning and reporting.
• Provide training to staff and allied professionals.

AADAC provides programs and services that are designed to prevent alcohol, other drug and gambling problems, and reduce the harms associated with substance abuse and problem gambling. Prevention strategies are intended to increase protective factors and reduce risk factors for the population as a whole, and within specific groups.

• Provide prevention consultation services through AADAC area offices and urban clinics.
• Collaborate with government and other key stakeholders to deliver prevention programming for youth, families and communities.
• Support the development of community prevention projects and programs.
• Provide consultation to employers in developing work-based initiatives that prevent and reduce the impact of substance use and problem gambling.
• Respond to high-risk behaviours through early intervention and harm reduction programming.

AADAC offers a broad continuum of treatment services that assist Albertans to improve or recover from the harmful effects of alcohol, other drug and gambling problems. Treatment is aimed at adults, youth, and their families who are displaying significant problems. Services include community-based outpatient counseling, day programs, crisis and detoxification services, short and long-term residential treatment, and overnight shelter. Specialized programs are available for youth, women, Aboriginal Albertans, business and industry referrals, and persons with opiate dependency or cocaine addiction.

• Provide crisis counselling and referrals through the toll-free AADAC help line.
• Operate and fund regional detoxification and shelter services.
• Operate and fund community-based outpatient counselling and day treatment programs.
• Operate and fund regional residential treatment programs.
• Operate and fund problem gambling treatment services.
• Maintain effective relationships with self-help groups and community agencies that assist clients in their recovery following treatment.