Consultation - Collaboration - Cooperation

Who We Are and What We DoWho We Are and What We DoA Collaborative Approach to Healthcare and A Collaborative Approach to Healthcare and

Public Health in the Pacific North WestPublic Health in the Pacific North West

Wayne DauphineeWayne DauphineeExecutive DirectorExecutive Director 20132013

• Pacific NorthWest Border Health Alliance • Canada and US Health Systems: 30K View• CA-US Pan Border Public Health Preparedness Council

Note: What you see on the following slides is not necessarily what you will hear as they were prepared primarily for post workshop reference

A non-profit organization, the PNWBHA’s mission is to promote public’s health preparedness. The Alliance works toward this mission through its activities in seven essential areas: •Disease epidemiology and surveillance, including food security •Emergency management and public health preparedness•Indigenous health•Emergency medical services•Public health laboratories•Risk communication•Public health law

The PNWBHA was founded in 2009 and is a member of the Canada-United States Pan Border Public Health Preparedness Council (PBPHPC)

PNWBHA promotes public health preparedness by actively working to:

Advocate the development and implementation of public preparedness policy;

Facilitate the sharing of health and related information; Cooperate regionally, nationally and internationally with other

organizations to promote public health preparedness; Encourage governments to provide sufficient resources for

disease prevention, surveillance and the promotion and protection of the public’s health

Advance opportunities for professional development.

British Columbia

Alaska Saskatchewan

Washington

Oregon

YukonIdaho

Montana

Core•Co-Chair (Canadian and United States representatives) •Signatory Representatives

Expanded•Working Group Leads

Liaison•Representative from the Public Health Agency of Canada•Representative from United States Department of Health and Human Services

PNWBHA’s future direction is focused on sustaining and building current efforts to strengthen public health preparedness. This includes:

1.Providing a community of practice where public health preparedness stakeholders from throughout the Pacific Northwest can come together to engage in dialogue on public health preparedness issues

2.Coordinating and supporting the extension of existing arrangements for: information sharing and protection; cross border movement of healthcare personnel and resources: and sharing public health laboratory capacity, throughout the region

3.Developing, disseminating and maintaining a map of the public health and healthcare infrastructure in the Pacific Northwest, including an emergency response capability index

What is PNWBHA’s future direction?What is PNWBHA’s future direction?

2012

ChallengeChallengeDifferences in epidemiological case definitions, communication

systems and professional licensure are among the issues that must

be resolved in order for provinces/territories and states to enhance

cross-border public health emergency preparedness and response.

Approach Approach The Canada – United States Pan Border Public Health Preparedness Council (PBPHPC) is comprised of health department/ministry representatives from the three regional border health collaboratives (Eastern, Great Lakes and Pacific NorthWest); four unaligned provinces and states (Alberta, Manitoba and North Dakota); and the Canada and United States federal government

Authority Authority The PBPHPC draws it authority from the November 2007 trilateral public health MOU entitled “Declaration among the Department of Health and Human Services of the United States of America, the Department of Health of Canada, the Public Health Agency of Canada and the Ministry of Health of the United Mexican States”.

Mandate Mandate The mandate of the PBPHPC is to facilitate regional pan-border public health preparedness collaborations to collectively strengthen capacity at all levels to address all nature of public health threats, including: responding to severe or novel outbreaks of infectious disease; augmenting disease surveillance in the face of an evolving or yet-undefined threat; or a need to address non-urgent public health issues that arise, e.g., transportation of infectious disease samples across the border.

Goals and Strategic Priorities Goals and Strategic Priorities

PBPHPC activity is chiefly focused on:

•Providing a forum for facilitating pan-border emergency preparedness collaboration •Promoting local and regional collaborations in emergency public health activities. •Ensuring all pan-border activities are deliberate, realistic and value added for all members. •Addressing Federal issues that are common to all Canada – U.S. cross border health collaborations and require resolution at the Federal level. •Engaging other pan-border stakeholders when appropriate to assist regional alliances and activities across the border; and •Avoiding duplication of established initiatives and alliances across the Canada – U.S. border

Our Health SystemsA 30,000 Foot Perspective

UNITED STATES

•A mixed private/public system.•Largest public (and private) spender in the world but with identified gaps in coverage.•Employer based coverage for many.•High administrative and legal costs.•Federal government provides funding through Medicare, Medicaid, SCHIP, and the VA•Fast adopters of new technology for those with good coverage.•Pockets of excellence in health management.•Per capita spending was USD $4,271

Life, liberty and the pursuit of happiness

CANADA

•A mix of public (70%) and private (30%) funding•Universal public coverage for hospital and physician services•Employer based and supplemental gov’t programs for other health services.•Low admin and legal costs.•Majority of health funding is provincial with some federal government providing some funding with conditions.•Slower adopters of new technology.•Per capita spending was USD $1,939

Peace, order and good government

Health System Overview Health System Overview

Acute CareSystem

Primary CareSystem

Public HealthSystem

• Public health is part of the overall continuum of health efforts• Core functions of disease prevention and control, health protection and health promotion, supported by surveillance, research,

policy and legislation, and human resources• Includes a wide range of activities, from school vaccine programs, to anti-tobacco advertising, to emergency preparedness and response

Public Health in CanadaPublic Health in Canada

Typical Provincial Health FundingTypical Provincial Health Funding

Income Source

Allocation

Typical Provincial Health SystemTypical Provincial Health System

Service DeliveryService DeliveryTypically Who Pays for What Typically Who Pays for What

What

PayerCanada US

IndividualProvince(Insurer)

Co-InsurerIndividua

lInsurer/

Co-InsurerState

Medically NecessaryServices1

Public Health

Dental

Optical

Prescription Drugs 2

Physical Therapies

Ambulance

1 Physician and diagnostic services and inpatient care, including all required

drug and therapies

2 Income based Pharmacare

How We Are OrganizedHow We Are OrganizedWashingtonWashington

How We Are OrganizedHow We Are OrganizedBritish ColumbiaBritish Columbia

Typical Regional Health AuthorityTypical Regional Health Authority

http://www.pnwbha.org

Consultation – Collaboration - Cooperation

2012