ARCHIVED — Vol. 146, No. 15 — July 18, 2012

Registration

SI/2012-49 July 18, 2012

OTHER THAN STATUTORY AUTHORITY

Order Amending the Order Respecting the Interim Federal Health Program, 2012

P.C. 2012-945 June 28, 2012

His Excellency the Governor General in Council, on the recommendation of the Minister of Citizenship and Immigration, makes the annexed Order Amending the Order Respecting the Interim Federal Health Program, 2012.

ORDER AMENDING THE ORDER RESPECTING THE INTERIM FEDERAL HEALTH PROGRAM, 2012

AMENDMENTS

1. (1) Section 1 of the Order Respecting the Interim Federal Health Program, 2012 (see footnote 1) is amended by adding the following in alphabetical order:

“expanded health care coverage” means coverage for the following services and products provided in Canada, as defined in the Interim Federal Health Program Policy of the Department of Citizenship and Immigration, as amended from time to time:

  • (a) hospital services;

  • (b) services of physicians licensed in Canada, registered nurses licensed in Canada and other health care professionals licensed in Canada;

  • (c) translation services for health purposes;

  • (d) laboratory, diagnostic and ambulance services;

  • (e) supplemental services; and

  • (f) supplemental products. (couverture des soins de santé élargie)

(2) Paragraph (d) of the definition “health care coverage” in section 1 of the Order is replaced by the following:

  • (d) immunization and medication, only if required to prevent or treat a disease posing a risk to public health or to treat a condition of public safety concern. (couverture des soins de santé)

(3) The portion of the definition “public health or public safety health care coverage” in section 1 of the Order before paragraph (a) is replaced by the following:

“public health or public safety health care coverage” means coverage for the following services and products provided in Canada, only if required to diagnose, prevent or treat a disease posing a risk to public health or to diagnose or treat a condition of public safety concern:

2. Section 3 of the Order is replaced by the following:

3. (1) The Minister may pay the cost of health care coverage incurred for protected persons, other than resettled refugees referred to in subsection 6.1(2), for a period set out in the Interim Federal Health Program Policy of the Department of Citizenship and Immigration, as amended from time to time.

(2) Despite subsection (1), the Minister may pay the cost of health care coverage incurred for protected persons who are resettled refugees only while they are under sponsorship under the Immigration and Refugee Protection Regulations.

3. Section 7 of the Order is replaced by the following:

6.1 (1) The Minister may pay the cost of expanded health care coverage and immigration medical examinations incurred in Canada for the following persons for a period set out in the Interim Federal Health Program Policy of the Department of Citizenship and Immigration, as amended from time to time:

  • (a) persons for whom the Minister exercises a power conferred under subsection 25.1(1) or 25.2(1) of the Act, if they are or were in receipt of governmental resettlement assistance in the form of income support as defined in the Interim Federal Health Program Policy of the Department of Citizenship and Immigration, as amended from time to time; and

  • (b) persons who have been issued a temporary resident permit under section 24 of the Act, if it has been determined, in accordance with ministerial instructions made under subsection 24(3) of the Act, that they are or may be victims of human trafficking.

(2) The Minister may pay the cost of expanded health care coverage incurred for resettled refugees, if they are or were in receipt of governmental resettlement assistance in the form of income support as defined in the Interim Federal Health Program Policy of the Department of Citizenship and Immigration, as amended from time to time, for a period set out in that Policy.

7. Despite sections 3 to 6, the Minister may, in exceptional and compelling circumstances, including when the Minister exercises a power conferred under subsection 25.2(1) of the Act, on his or her own initiative and for the period that he or she determines, pay the cost incurred in Canada of any of the following:

  • (a) health care coverage;

  • (b) public health or public safety health care coverage;

  • (c) immigration medical examinations; or

  • (d) immunization and medication, only if required to prevent or treat a disease posing a risk to public health or to treat a condition of public safety concern.

4. The Order is amended by adding the following after section 9:

9.1 Any payment referred to in sections 3 to 9 shall be made in accordance with the benefit grids referred to in the Interim Federal Health Program Policy of the Department of Citizenship and Immigration, as amended from time to time.

5. Section 10 of the Order is replaced by the following:

10. (1) The Minister is not authorized to make a payment under sections 3 to 6 for persons who are or were eligible under any provincial health insurance plan or program, whether or not an application has been made to the plan or program.

(2) Despite subsection (1), the Minister may pay the cost of immunization and medication incurred for protected persons who are resettled refugees while they are under sponsorship under the Immigration and Refugee Protection Regulations, but only if required to prevent or treat a disease posing a risk to public health or to treat a condition of public safety concern.

(3) The Minister is not authorized to make a payment under section 6.1 for persons referred to in that section for any services or products for which they are eligible under any provincial health insurance plan or program, without regard to the amount that may be recovered under that plan or program for those services or products.

(4) The Minister is not authorized to make a payment under section 9 for persons referred to in that section who are eligible under any provincial health insurance plan or program, whether or not an application has been made to the plan or program.

(5) The Minister is not authorized to make a payment under this Order for any services or products for which a person may make a claim under any private insurance plan, without regard to the amount that may be recovered under that plan for those services or products.

(6) The Minister is not authorized to make a payment under this Order for persons who are Canadian citizens.

6. The French version of the Order is amended by replacing “ministère de l’Immigration et de la Citoyenneté” with “ministère de la Citoyenneté et de l’Immigration” in the following provisions:

  • (a) the portion of the definition “couverture des soins de santé” in section 1 before paragraph (a);

  • (b) paragraph (b) of the definition of “maladie présentant un risque pour la santé publique” in section 1; and

  • (c) section 9.

COMING INTO FORCE

7. This Order comes into force immediately after the coming into force of section 1 of the Order Respecting the Interim Federal Health Program, 2012, as enacted by Order in Council P.C. 2012-433 of April 5, 2012 and registered as SI/2012-26.

EXPLANATORY NOTE

(This note is not part of the Order.)

Proposal

The Minister of Citizenship and Immigration be authorized to amend the Order Respecting the Interim Federal Health Program, 2012 (2012 OIC) to assist victims of human trafficking in Canada and to help Canada to meet its refugee resettlement commitments. This amendment will allow for the payment of expanded health benefits through the Interim Federal Health Program (IFHP) to those resettled refugees and persons admitted under a public policy or through humanitarian and compassionate (H and C) grounds in receipt of resettlement assistance in the form of income support from the federal or Quebec government and to victims of human trafficking in persons.

Purpose

To address the unintended impact of the 2012 OIC on another Budget 2012 commitment to convert 1 000 government-assisted refugee (GAR) spaces in the Immigration Levels Plan to spaces for 1 000 privately sponsored refugees (PSRs), Citizenship and Immigration Canada (CIC) is recommending that the 2012 OIC be amended. Furthermore, to optimize Canada’s ability to continue to accept referrals from the United Nations High Commissioner for Refugees (UNHCR), to uphold Canada’s efforts to protect victims of human trafficking and to provide the Government with the authority to cover the costs of expanded health benefits to public policy and H and C arrivals who receive resettlement assistance in the form of income support from the federal or Quebec government, an amended order in council (OIC) is recommended.

The proposed changes will cover expanded health benefits to those GARs, PSRs, public policy and H and C arrivals (e.g. Afghan interpreter initiative) who receive resettlement assistance in the form of income support from the federal or Quebec government, and victims of human trafficking in persons. This amendment would restore IFHP coverage for these clients to the same benefits covered under the 1957 Order in Council, meaning coverage that includes products such as medications, vision products and assistive devices and services such as emergency dental care, psychotherapy by registered clinical psychologists, home care and long-term care.

The focus of the 2012 OIC on containing costs and promoting fairness while protecting the health and safety of Canadians remains unchanged. Asylum seekers awaiting a decision and rejected refugee claimants will continue to be subject to the limited coverage introduced by the 2012 OIC. The amended 2012 OIC maintains the Government’s commitment to ensuring that IFHP beneficiaries do not receive benefits that are more generous than what Canadians receive through government-funded benefit programs.

Background

As part of Budget 2012, the Government introduced changes to the IFHP to promote fairness, strengthen eligibility and contain costs while maintaining protection of public health and public safety for Canadians. These changes come into effect on June 30, 2012. The IFHP is a discretionary program that provides temporary, limited coverage of health-care benefits to eligible protected persons (this includes resettled refugees), refugee claimants, rejected refugee claimants before their departure from Canada and other specified groups. The IFHP is currently operating under the 1957 OIC and will do so until June 29, 2012, when the 1957 OIC will be repealed and the Order Respecting the Interim Federal Health Program, 2012 (2012 OIC) comes into force on June 30, 2012.

The 2012 OIC continues to cover primary health services provided in Canada for protected persons and refugee claimants from non-designated countries of origin, as well as medication and immunizations necessary to prevent and treat diseases that pose a risk to public health or to treat conditions of public safety concern. It covers health-care services and products needed to protect public health and safety for rejected refugee claimants and claimants from designated countries of origin. Unless amended, it will no longer cover supplemental health benefits (e.g. drugs, assistive devices, dental or vision care) for any IFHP beneficiary, including resettled refugees and public policy applicants who are victims of human trafficking.

Resettled refugees

Resettled refugees who receive income support from the federal or Quebec government or from private sponsors are ineligible to apply for income support from provincial or territorial (PT) social assistance programs. The income support provided to resettled refugees by the Government during their first year in Canada is geared to be on par with social assistance rates. Persons on PT social assistance are eligible for supplemental health benefits similar to what was provided under IFHP, prior to the changes introduced in Budget 2012. Resettled refugees, however, because they are ineligible for social assistance in their first year in Canada, cannot access PT supplemental health coverage. The amendment to the 2012 OIC would provide coverage for the cost of expanded health benefits to resettled refugees who receive resettlement assistance in the form of income support from the federal or Quebec government.

In preparing to implement the 2012 OIC, it has become clear that one element of the IFHP reform will have a serious impact on the Department’s ability to implement another Budget 2012 commitment — the conversion of 1 000 government-assisted refugee (GAR) spaces in the Immigration Levels Plan to spaces for 1 000 privately sponsored refugees (PSRS) with some income support. This initiative is dependent on private sponsors coming forward to sponsor the 1 000 UNHCR-referred refugees selected by the Government of Canada. While it is expected that sponsors will cover health costs for their current caseload which is primarily family-based, sponsors have indicated that they are not prepared to cover unknown health costs for strangers. It has become clear also that the planned IFHP reforms will affect UNHCR’s ability to refer refugees in need of protection to Canada. UNHCR would try to identify and avoid referring refugees likely to need health care not covered by the IFHP. In the absence of private sector support and given the expected impact on UNHCR referrals, Canada’s refugee resettlement immigration levels might not be met.

Public policy and humanitarian and compassionate recipients

Persons admitted under a public policy or on H and C grounds receiving income support from the federal or Quebec government are ineligible similarly to apply for income support from PT social assistance programs. The amendment to the 2012 OIC would also provide coverage for the cost of expanded health benefits to public policy or H and C arrivals who receive resettlement assistance in the form of income support from the federal or Quebec government. Public policy applicants who receive this assistance are groups for whom the Minister has identified a compelling humanitarian need where settlement needs are comparable to those of GARs and where no other means of financial support is available. The persons may be in a refugee-like situation but are often unable to leave their country.

Victims of human trafficking

The 2012 OIC removes coverage of psychological counselling provided by registered clinical psychologists, a health benefit that is important for supporting victims of human trafficking, to cooperate with Government of Canada efforts to combat trafficking in persons. The revised 2012 OIC would provide coverage for the cost of expanded benefits to victims of human trafficking in Canada.

Financial implications

This proposal is expected to increase IFHP costs by $1M to $2M annually.

Departmental contact

Dr. Danielle Grondin
Director General
Health Branch
Citizenship and Immigration Canada
Telephone: 613-946-5597
Email: Danielle.Grondin@cic.gc.ca

Footnote 1
SI/2012-26