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Duclos warns provinces to stop letting patients be charged for virtual health care

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Provinces that continue to allow private clinics to charge patients directly for virtual health care could see their future federal funding clawed back, as the government moved Friday to put an end to a proliferation of for-profit virtual care in Canada.

Health Minister Jean-Yves Duclos said he intends to clarify that virtual care is covered by the Canada Health Act, the same way the federal government clarified in 2018 that it applied to all medically necessary diagnostic tests.

That latter point led Duclos Friday to claw back health transfers to seven provinces for allowing private clinics to charge patients directly for MRIs, CT scans and other tests.

He said the move is mandatory under the Canada Health Act. And he warned the same thing could happen in the future if provinces don’t tackle fee-for-service in virtual care for services that would be paid for through the public health system if they were provided in person by a doctor.

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“It is critical that access to medically necessary services, whether provided in person or virtually, remains based on medical need and free of charge,” said Duclos.

Duclos said virtual care grew from about three per cent of health services in Canada before COVID-19 to about 18 per cent now. He called that a positive development, but said it cannot be used to allow more user fees in the health care system.

Dr. Brett Belchetz, the CEO of Maple, an online medical clinic, said he thinks the federal government is opening a legal can of worms.

He said Canadian law has been clear that fees can be charged for services that aren’t medically necessary and that provinces get to determine what that applies to. If provinces won’t start paying for virtual visits, he said he doesn’t think Ottawa can prevent patients from paying for it themselves.

“I’m very confused about what the announcement actually means,” he said.

“Because I cannot see any legal rule in which the government can now say that they will have services that they do not cover, but yet Canadians do not have the right to pay for themselves.”

Clawbacks to federal transfers over private billing are not new. Between 2015 and 2022, an average of $15 million a year was clawed back from provinces for user fees charged by private surgical clinics, or for abortion services.

This year, eight provinces are losing $82.5 million, of which only $6 million is not related to diagnostic tests.

When the clarification that all medically necessary diagnostic tests must be covered was made in 2018, Ottawa gave provinces and territories two years to address the problem of patients being charged fees.

But in 2020-21, fees were still being collected in seven provinces, adding up to a total of $76 million. The same amounts are being taken from their health transfers this month.

Quebec’s $41.9-million clawback accounts for more than half that amount, followed by British Columbia at $17 million and Alberta at $13.8 million.

In total, the clawbacks account for just 0.2 per cent of the transfers Canada issued provinces and territories in 2020-21.

Quebec Health Minister Christian Dubé criticized the clawbacks and urged Ottawa to offer more money to the provinces, not less.

Dubé also argued that the private sector should be used to complement the public sector, to allow for better care for the population.

Duclos said provinces that change policies or fix issues that allowed for inappropriate private billing within the next two years can get the money returned.

B.C. took a number of steps since 2018 to expand access to MRIs and other tests in public hospitals and clinics, and in 2019 made it illegal for clinics to charge patients for diagnostic tests. As a result, $15 million that was clawed back in the last two years is now being returned.

B.C. Health Minister Adrian Dix said no government in Canada, provincial or federal, has taken as much action as his to make the public system work and bring people back into it, citing a significant increase in MRI tests conducted in public settings. He accused Ottawa of taking an uneven approach.

“Since 2017, we’ve taken action again and again. This is particularly true in diagnostic care,” he said.

“And British Columbia takes the process seriously. We report seriously on the results here. And the federal government enforces the Canada Health Act intermittently across the country.”

Saskatchewan is losing $742,447 from this clawback, related to its seven-year-old policy to allow private clinics to charge directly for MRIs and CT scans as long as they provide an equal number of scans for free to people on the public waiting list.

The province’s Health Minister Paul Merriman said the move added capacity to the system to do more tests for no extra cost, and Saskatchewan has been trying to get Ottawa to discuss the matter for more than six years.

“To date, there has been a complete unwillingness on the part of the federal government to approach the issue with an open mind,” Merriman said.

Alberta Health Minister Jason Copping said the province fully supports public health insurance covering medically necessary diagnostic imaging. But he said there is a dispute between many provinces and the federal government about how Ottawa is interpreting the term “medically necessary.”

“I understand there have been ongoing conversations about the interpretation of medically necessary and payment for medically necessary, and how it works in the regulations and what’s allowed and what’s not allowed,” said Copping.

His office said the province has requested a formal legal opinion on Ottawa’s position.

This report by The Canadian Press was first published March 10, 2023.

— With files from Colette Derworiz in Calgary, Brittany Hobson in Winnipeg and La Presse Canadienne.

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The Losani Family Foundation celebrates 10 years of giving back

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This year, the Losani Family Foundation is celebrating its 10-year anniversary. Over the past decade, the Foundation has made a significant impact on the communities it serves in three major core areas:

  • support for vulnerable women,
  • support for children,
  • support for food banks.

As the foundation’s parent company, Losani Homes is a leading developer operating in the Hamilton/GTA area, with a long-standing history of supporting charitable causes. Losani Homes’ charitable initiatives have been active in the local community for over 40 years, ever since the Losani family first immigrated to Canada. Some early initiatives included supporting children’s programs through an emphasis on physical activity, literacy programs, and hospital facilities.

By 2013, the Losani Family formalized their commitment to local communities by founding the Losani Family Foundation, which has been making a sizable impact on charitable organizations, locally and internationally, donating over $1.6 million since its inception in 2013.

CEO of Losani Homes, Fred Losani, has been the driving force behind corporate and family philanthropy over the last decade. With a deep sense of care and stewardship in support of local and international communities, Fred and the company’s employees have worked tirelessly to support housing, clean water, health, and numerous other important causes.

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The Losani Family Foundation has supported multiple organizations over the years, including but not limited to: Good Shepherd, St. Matthew’s House, and Hamilton Food Share. The Losani Family Foundation’s passion for giving back has also inspired many business associates in the local community.

In 2006, Fred and five other Hamilton business leaders raised a staggering $1.5 million for local children and families by trekking to the North Pole, and again in 2008, where they trekked to the South Pole. They even completed the entire length of the Bruce Trail in 2012. These achievements were the spark that led to the Foundation’s inception, and they have continued to make a difference in countless lives since.

In 2017, Losani Homes and the Losani Family Foundation received the Gold Award for Building Community Spirit at the National Association of Home Builders Awards (NAHB).

At that time, Fred Losani stated: “We are honoured to receive this special recognition for our efforts at both the local and international levels. We are fortunate that we have achieved great success in our home and land development business. We take this responsibility seriously, but we are equally committed to and proud of the work done through the Losani Family Foundation.”

The Losani Family Foundation has consistently professed that food is an essential element of life, is at the heart of any family gathering and is a core value of the Foundation. The Losani Family Foundation has worked with numerous food banks over the years, one of the closest relationships being with Hamilton Food Share, enabling the team to support vulnerable people in the community. The Losani Family Foundation has worked closely with Hamilton Food Share to support families at risk of facing food insecurity issues. Hundreds of thousands of dollars have been donated by the Losani Family Foundation to this vital Hamilton organization.

In 2022, the Losani Family Foundation further supported families facing poverty by contributing $9,500 to Food4Kidz to establish a relationship with the organization to address the issue of food insecurity for children in close to 70 Hamilton schools. The Losani team also visited CityKidz, another non-profit organization close to the Foundation’s heart. Team members worked on packing family care kids and assembling boxes for meal kits. Along with their volunteer labour, the Losani Family Foundation donated $25,000 to help improve the lives of local children by supporting the work of CityKidz. To date, the Losani Family Foundation has donated well over $200,000 to CityKidz.

Looking towards 2023 and beyond, the Losani Family Foundation will be supporting these and numerous other charitable initiatives. Their aim is to provide significant financial support to grassroots charities in local communities.

In 2023, the team at Losani Homes will embark on multiple visits to support our community partners in Hamilton, Stoney Creek, Brantford, Paris, Grimsby, and Beamsville.

The Losani Family Foundation continues to set a high standard for philanthropy and remains steadfast in its commitment to making a difference in our local communities.

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Vancouver park board offers tips on how to ‘respect’ city’s coyotes

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VANCOUVER — Now that coyote denning season is in full swing, the Vancouver park board is offering some tips for “peaceful coexistence” between the animals and humans.

Their pups are born in the spring, and the board says that makes coyotes more active as they protect their dens and seek food for their young.

Normally they’re only seen at dawn and dusk, but the board says that behaviour changes in spring, when they’re spotted in the daytime and they become bolder or stand their ground if they perceive a threat.

Coyotes are found across Vancouver and prefer sheltered, wooded areas to raise their families, so the board says it will occasionally close trails in high-traffic locations like Stanley Park where they are known to frequent.

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Its tips for living without conflict with the animals include to never leave or offer food — punishable by a $500 fine if offenders are caught — keep pets on a leash, give wildlife space and if you see a coyote, slowly back away.

There have been a number of high-profile coyote attacks in the city over the years, including dozens in spring and summer of 2021 in Stanley Park, some involving children bitten while with their families.

This report by The Canadian Press was first published March 21, 2023.

 

The Canadian Press

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Military expecting to save $30M per year with targeted housing benefit for troops

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OTTAWA — The Canadian Armed Forces is rolling out a new housing benefit that a senior commander says will better help troops struggling to find affordable accommodations while saving millions of dollars every year.

The Canadian Forces Housing Differential will supplement the incomes of members who have to live and work in areas of the country with high rental costs.

That includes Canadian Forces Base Comox on Vancouver Island, where some members were recently told they could contact Habitat for Humanity if they were having trouble finding a place to live.

The benefit is set to come into effect on July 1 and will replace an existing allowance called the post living differential, or PLD, that sought to offset the cost of living and working in particularly expensive communities.

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Unlike that allowance, whose rates have been frozen since 2009, the new housing benefit will be tied to salary to help those who need it most, said Brig.-Gen. Virginia Tattersall, the military’s director general of compensation and benefits.

The result is that thousands of members who don’t currently qualify for the PLD allowance will start to receive the housing benefit, while thousands of others will see their PLD cash cut off — at a net savings of about $30 million per year.

“This benefit is about us being equitable,” Tattersall said in an interview. “It is truly trying to look after those who need it the most. So hence why it is more the junior ranks that will benefit from this than it is the senior ranks.”

She added the aim is to ensure no member is forced to spend more than between 25 per cent and 35 per cent of their monthly salary on rent. An outside company has been hired to assess average rental prices near bases.

Online forums catering to military personnel are rife with stories and complaints from Armed Forces members about the lack of affordable housing near military bases where they are required to work.

The problem is exacerbated by the cyclical nature of military postings, as troops are routinely forced to relocate from one part of the country to another due to operational demands and career progression.

Younger and more junior members face an especially hard time in certain communities such as Comox, Victoria and Halifax, where housing is extremely limited or expensive.

There is also a critical shortage of housing on bases, with thousands of military members and their families currently on wait-lists while promises to build new accommodations largely stuck in neutral.

To ease the problem, the local base commander at CFB Esquimalt near Victoria has started letting new sailors live in their training quarters for months after their initial training is finished.

The focus on housing rather than overall cost-of-living reflects the main cost disparity of living in different parts of the country, Tattersall said, unlike in the past when cost variances were far greater.

“Cost of living per se is relatively equal across the country, the one thing that does stand out is that cost of housing, or that affordability of housing,” she said.

“And so that’s why we’ve focused the benefit in on that issue, because that more seems to be the real challenge for our members.”

Tying the new housing benefit to salary will ensure those who are really struggling get the help they need while cutting down on spending, she added. Armed Forces members living in military housing will also not qualify.

The new housing benefit will cost about $150 million per year, compared to $180 million for the PLD allowance.

“And so part of finding that sweet spot in terms of something that looked after members was also ensuring that we brought ourselves back within the envelope of funding that had been authorized,” she said.

The military estimates that about 28,000 Armed Forces members will qualify for the new housing benefit, which represents about 6,300 more than currently receive the PLD.

However, about 7,700 members who have been receiving the existing allowance will be cut off. While the military says most of those already live in military housing or have higher salaries, the move is likely to spark complaints.

This report by The Canadian Press was first published March 21, 2023.

 

Lee Berthiaume, The Canadian Press

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