Friday, July 14, 2017

But AHS has struggled. There have been scandals over large executive payouts, questionable expense spending, organizational confusion, bureaucratic turf wars, queue-jumping and long wait lists for care. Panel member Dr. Dennis Kendel says the Alberta experience has provided lessons for Saskatchewan, including the need for rigorous, advance planning. “The fundamental flaw in the Alberta model is they hadn’t thought out a management structure — essentially there was a single entity, Alberta Health Services, and nobody knew the next day who was actually accountable for what,” said Kendel.

Too much money is being spent on top dogs in the health care system. We can't afford these rich payouts and we don't want to pay for these payouts when we aren't getting deliverables.
Sooner or later government will have to deal with the shortfall of cash and cut accordingly.
We're not going to put up with increased taxes to pay for the elite of our society while our own families get by on less and less.

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One health authority won't stop the elite in our society from benefiting excessively from the sky high compensation packages offered to them but really it's not their fault for taking the money, benefits and expense accounts. It's not their fault that government wastes the money. It's the fault of the government.
In any case, the one health authority will get rid of a bit of the duplication costs but I'm betting that the money saved will not go to front line workers or patients--it's going to go into the pockets of the top dogs in the system.


Monumental changes to Saskatchewan’s health care: The province will consolidate the 12 existing regional health authorities (RHAs) into one mega health authority.
LEADERPOST.COM

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when the troubles came
they did not come in dabs and dribbles
but in battalions
and it took all I had inside me
to keep going
but one day I reversed the situation
I saw the troubles
as the ordinary ups and downs
on the journey of life
I took my poems
and contained the disease


when the troubles came
I was on my knees
but I got off my knees
and became determined
I know I am nobody
and I can't change anything
but I can document
the failures in the system
and write the history of disbelief
on the part of the citizens
we who pay for everything


when the troubles came
I faced them and I did not back away
I stood up for my family
and I planned the money carefully
so that I had a way
in other words I did not depend on the government
of Alberta    which is fiscally irresponsible
I did not depend on the federal government
which is also spending a major chunk of money
no   I depended only on myself
and I wrote out the history of fiscal waste at all levels


when the troubles came
I understood this was  a long term game
that was being played by the powerful
the elite survive and prosper
while the ordinary family suffers
so I took the chaos into me
and I transformed myself
I made myself strong and told myself
this is the way it is going forward
you must be careful with the resources you have
while all others squander the public dollars on perks and entitlement


https://www.youtube.com/watch?v=5ZDsCJ4rGD4

ZAZ - "Si jamais j'oublie" [Official Video]



https://www.covenanthealth.ca/corporate-information/financial-information/compensation-disclosure

Compensation Disclosure: Public Sector Compensation Transparency Act

Covenant Health is committed to practicing wise stewardship and sharing information about how we use resources entrusted to us. We disclose compensation for employees receiving compensation over an established threshold of compensation as outlined in the Public Sector Compensation Transparency Act. In 2016, the threshold was $126,375, and in 2015 it was $125,000. The 2016 information is visible, click the tab to view the 2015 information.
The compensation information released is total annual compensation, which includes base salary, overtime, shift premiums, weekend premiums, on-call pay, sick pay, vacation pay, benefits and severance.
The 2016 Covenant Health disclosure list includes approximately 1.6 per cent of Covenant Health staff (190 employees). About 49 percent of the group is unionized staff, including registered nurses, technicians, psychologists, pharmacists, and others. 51 percent are non-union staff, including senior leaders and managers.
Covenant Health regularly posts salaries and expenses of the Covenant Health executive team on the external website. Total severance information is disclosed as part of our annual audited financial statements.
Name More Options
Position 
Year 
Compensation 
Other 
Severance 
Attachments 
Cozens,DeannePharmacist I2016$ 129,324.32$ 28,221.82$ 0.00
Cresswell,WilmaDirector2016$ 141,285.82$ 25,098.25$ 0.00
Cruz,IrishRegistered Nurse2016$ 134,415.74$ 23,092.47$ 0.00
Cseke,LindaManager2016$ 143,463.80$ 24,591.93$ 0.00
Cunliffe,MaryDirector2016$ 168,256.93$ 29,965.64$ 0.00
Deng,JingRegistered Nurse2016$ 131,279.76$ 18,760.46$ 0.00
Deuna,EvelynRegistered Nurse2016$ 141,221.11$ 23,371.97$ 0.00
Dimnik,MichaelBoard Member2016$ 1,000.00$ 0.00$ 0.00
Doonanco,RobertCommittee Member2016$ 0.00$ 0.00$ 0.00
Dumelie,PatrickPresident & CEO2016$ 544,276.79$ 31,280.10$ 0.00Contract


Excessive compensation is at the root of the problems in the health system. We can't continue to pay exorbitant salaries, benefits, pensions and expenses while we struggle as families just to pay for the ordinary bills of life without these perks.
Time to cut and cut deep.


Two lab pathologists, a geriatrician and a community dentist were among the top 15 salary earners at Alberta Health Services last year.
CBC.CA

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http://www.cbc.ca/news/canada/edmonton/ahs-salary-disclosure-places-current-president-at-top-of-list-1.3655294

AHS salary disclosure places current president at top of list

Dr. Verna Yiu was the top earner in 2015 when she was still an AHS vice-president

By Michelle Bellefontaine, CBC News Posted: Jun 27, 2016 6:00 PM MT Last Updated: Jun 27, 2016 6:00 PM MT
Yiu was appointed permanent president of AHS in May after serving in the interim role since January.
Yiu was appointed permanent president of AHS in May after serving in the interim role since January.
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Two lab pathologists, a geriatrician and a community dentist were among the top 15 salary earners at Alberta Health Services last year.
Dr. Verna Yiu, now the health board's president, was the top earner last year when she was a vice-president seconded from the University of Alberta. Yiu earned $568,321 in base salary last year. She became AHS president last month after moving to the interim role in January.
Vicki Kaminski, the former AHS president and CEO, placed second with a salary of $537,999. Dr. Kevin Worry, director of the North Zone of AHS, had the third-highest base salary of $483,520.
Dr. Peter Craighead, a medical oncologist, placed fourth with earnings of $457,593.
Craighead was a zone clinical department head and academic head for oncology until September 2015. He continues his practice as a radiation oncologist.
Antonietta Paladino, the community dentist, earned a base salary of $410,204 in 2015, placing her 13th on the list. Roland Ikuta, Royal College Geriatrician, placed 10th, earning $457,593.
Lab pathologists Mirielle Kattar and Safwat Girgis earned $475,723 and  $418,247 respectively.
Under the government's new disclosure rules, agencies, boards and commissions must reveal salaries of people making more than $125,000 a year by June 30. This is the first time many of these salaries have come to light.
Other high earners in the top 15 include 2 vice-presidents/medical directors, another zone medical director, and the associate chief medical officer.
Physicians on this list are compensated by salary. Lists for doctors who are paid by fee for service will be revealed at a later date. They won't be on the June 30th sunshine list because details on how to report them are still being worked out between the health and justice ministries.
Several more people in the top 15 are listed as physicians. They are medical oncologists working for AHS.
The salary disclosure list also reveals compensation for 10 vice-presidents. Dr. David Mador, vice-president and medical director, was the top earner of the vice-presidents behind Yiu, with a salary of $454,134.

The 10 vice-presidents earned a total of $3,656,903 in salary last year.
“Times are tough and the responsible thing to do is to create a long-term, sustainable public health-care system,” said Hoffman. ---Right so if you know what the problem is why aren't you cutting the salaries, benefits, pension plans, expenses of the elite and the major number of folks at AHS and Covenant Health who are making tons of cash for no deliverables that I can detect? Chatter is not a deliverable.

While the NDP government looks to rein in health-care spending, Health Minister Sarah Hoffman isn’t taking aim at top earners within Alberta Health Services at this point. New discl…
CALGARYHERALD.COM

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http://calgaryherald.com/news/politics/ahs-boasts-big-salaries-as-government-eyes-health-care-c

AHS boasts big salaries as government eyes health care costs

Published on: June 28, 2016 | Last Updated: June 28, 2016 6:32 PM MDT
Sarah Hoffman, Minister of Health.
Sarah Hoffman, Minister of Health. SHAUGHN BUTTS / POSTMEDIA NEWS
While the NDP government looks to rein in health-care spending, Health Minister Sarah Hoffman isn’t taking aim at top earners within Alberta Health Services at this point.
New disclosure rules for agencies, boards and commissions show 2,390 Alberta Health Services employees earned over $125,000 in 2015.
The AHS sunshine list, released in the last week, shows total compensation for those individuals sitting at $358,856,877. The provincial health authority has more than 100,000 employees and a total payroll of over $6 billion.
The top earner on the list is Dr. Verna Yiu, now AHS’s CEO, who was vice-president for most of the year and made $568,321. Former CEO Vickie Kaminski, who resigned last November, made $537,999.
The remainder of the top 10 highest earners, who all make over $400,000, includes five of the health authority’s medical directors, an oncologist, a lab pathologist and a geriatrician.
The NDP government has vowed to “bend the curve” to bring down health-care spending, though expenditures went up significantly to $20.4 billion in this spring’s budget, with $14.3 billion allocated to AHS.
In an interview Tuesday, Hoffman said she believes the high-level salaries at AHS are reasonable compared to what is seen in other jurisdictions, but noted that all compensation in the agencies, boards and commissions sector is under review as the NDP faces a projected $10.4-billion shortfall.
“That will determine exactly where everybody should be falling and providing a way, if it’s determined that salaries are greater than the comparators … that will be adjusted as we are moving forward,” she said, noting that about a third of the names on the AHS sunshine list are executives in management positions.
A report by the Conference Board of Canada warned last week that Alberta faced a string of deficits in part because of lofty health-care spending, the highest per capita of any province and 33 per cent above the national average.
Health spending in Alberta has grown by six per cent annually over the past decade and now makes up 40 per cent of provincial expenditures.
Hoffman has been charged with cutting the rate of increase on health spending to two per cent annually by 2018, with a focus on three major expenses: hospitals, drugs and physician compensation.
The AHS sunshine list only contains salaried physicians and does not list the majority of doctors who operate on the fee-for-service model.
Hoffman said health workers who show up on the list are “nurses, lab techs, front-line staff that don’t necessarily want to be working overtime but when they’re called, they roll up their sleeves.”
But she acknowledged that compensation levels for health-care professionals will be scrutinized as the government tries to get spending in the sector under control.
“Times are tough and the responsible thing to do is to create a long-term, sustainable public health-care system,” said Hoffman.
United Nurses of Alberta president Heather Smith said about 450 nurses represented by the union appear on the sunshine list but more than 26,000 of her members work for AHS.
Nurses who earn enough to make it on to the list usually do so because they are working on call, often for specialized programs, she said.
The nurses union’s contract expires next year, and Smith said the situation is “tense” even before bargaining begins as AHS signals that it wants to cut costs.
“It’s been going on for some time, this ‘bending the curve,’ and what they’re really talking about is trying to cheapen the workforce,” said Smith.
Wildrose health critic Drew Barnes said the salary disclosure shows the province needs to reduce costs of both the bureaucracy of AHS and health-care workers.
Wildrose MLA Drew Barnes
Wildrose MLA Drew Barnes BRUCE EDWARDS / EDMONTON JOURNAL
He said the NDP government should propose a wage rollback when negotiating new contracts with health-care unions.
“I think in these financial times, the government needs to go in with the taxpayer in mind,” said Barnes. “The government needs to go in with maximum value for Albertans in mind. And when so many of the private sector have looked at job losses or pay reductions, I think that would be a good place to start.”
The original sunshine list for government employees was brought in by the former PC administration.
Under the NDP, disclosure rules have been extended to include more than 150 agencies, boards and commissions.
Among the other institutions to release their salary figures ahead of the June 30 deadline is SAIT, which had 150 employees make over $125,000. The top earner was president David Ross, who made $489,071.

jwood@postmedia.com

http://leaderpost.com/news/local-news/province-to-move-from-12-health-regions-to-one-provincial-health-authority

Saskatchewan to move from 12 health regions to one provincial health authority

Published on: January 4, 2017 | Last Updated: January 6, 2017 11:49 AM CST
Greg Ottenbreit, from left, minister responsible for Rural and Remote Health and Health Minister Jim Reiter are joined Wednesday by Dr. Dennis Kendel and Tyler Bragg, members of the Advisory Panel on Health System Structure, at the release of the panel's report which recommends consolidating the 12 existing Regional Health Authorities to one Provincial Health Authority.
Greg Ottenbreit, from left, minister responsible for Rural and Remote Health and Health Minister Jim Reiter are joined Wednesday by Dr. Dennis Kendel and Tyler Bragg, members of the Advisory Panel on Health System Structure, at the release of the panel's report which recommends consolidating the 12 existing Regional Health Authorities to one Provincial Health Authority. TROY FLEECE / REGINA LEADER-POST
As moves are made to create one health authority to cover all of Saskatchewan, Health Minister Jim Reiter believes health care in the province can improve through the changes.
“This is a consolidation of management and governance, it’s not a consolidation of the front-line health care,” Reiter said Wednesday. “If we do this properly, you will see no difference or hopefully some improvements.”
Most provinces have reorganized governance and management of their health regions in the past number of years, he noted.
The intent is that there will be no job loss among front-line health-care workers.
“Patient care is No. 1,” Reiter said. “We don’t want this to impact patient care. This is about reorganizing and consolidating governance and the boards and management.”
Currently, there are 12 health region CEOs and 62 vice-presidents.
“How the new management structure will look, we’ve got some work to do there yet,” Reiter said. “Obviously though, there’s no way to sugar-coat it, there will be some management positions eliminated.”
He didn’t have an exact number of lost jobs, which will include board members as the province move to one board to cover all of Saskatchewan.
No decision has been made about where the head office of the Provincial Health Authority will operate from. Nor has a CEO been chosen.
The report, prepared by a three-member panel, also recommends consolidating dispatch and delivery for emergency medical services, which it says are delivered by a large number of vendors with poor integration.
There are just over 100 ambulance services in Saskatchewan.
Provincial auditor Judy Ferguson said last month that the borders for a region are artificial when it comes to ambulance service and, in some cases, service in another region may be closer to an emergency.
Health Minister Jim Reiter at the release of the panel's report which recommends consolidating the 12 existing Regional Health Authorities to one Provincial Health Authority.
Health Minister Jim Reiter at the release of the panel’s report which recommends consolidating the 12 existing Regional Health Authorities to one Provincial Health Authority. TROY FLEECE / REGINA LEADER-POST
Changes already in the works
Work on implementation planning has already begun at the Ministry of Health. While the date the new Provincial Health Authority will come into being is still being determined, it is anticipated to occur in the fall.
Reiter said the priority will be planning for a smooth transition and ensuring patients are “always the focus.”
With severance payouts, he acknowledged the costs will be high in the first year.
“In the outlying years, there will be cost savings … Each regional health authority has their own (information technology) people — that will be centralized,” Reiter said. “We will have one IT structure for the entire province.”
He stressed the changes are to improve patient care.
“We’re here to look after the interests of the citizens of Saskatchewan,” Reiter said. “I don’t think the average citizen is so concerned about what the management structure of health care looks like as they are about front-line service. They’re concerned about services from doctors and nurses and diagnostic people and the various health-care providers. What we’re trying to deal with is the best way to provide that front-line health-care services.”
The province is trying to save money due to a big drop in natural resource revenue that has pushed the government’s deficit for this year close to $1 billion.
“With the Sask. Party government, consolidation is code for cuts and closures — cuts to front-line services, cuts to jobs and closures of health-care facilities,” said New Democrat health critic Danielle Chartier.
Month-long consultation elicited 300 responses
The advisory panel held consultations and received input during a formal feedback process that was open to the public from Aug. 29-Sept. 26.
It received more than 300 submissions from a diverse group of people and organizations, including patients, care providers, unions and indigenous leaders.
The panel also held 30 face-to-face consultations with key partners and stakeholders across the health system and reached out to health-care leaders in Canada who had experience with the consolidation of health system governance and management.
It’s not the first time health regions have been consolidated in Saskatchewan.
There were 32 health districts formed in 1992. In 2002, the province created the current 12 health regions plus the Athabasca Health Authority (which oversees northern health and will remain in place under the new plan).
The provincial system serves about 1.2 million people with a budget of $5.1 billion.
Alberta took similar action in 2008 when it rolled all regional health authorities into the centralized Alberta Health Services superboard in order to save money and improve care.
But AHS has struggled. There have been scandals over large executive payouts, questionable expense spending, organizational confusion, bureaucratic turf wars, queue-jumping and long wait lists for care.
Panel member Dr. Dennis Kendel says the Alberta experience has provided lessons for Saskatchewan, including the need for rigorous, advance planning.

“The fundamental flaw in the Alberta model is they hadn’t thought out a management structure — essentially there was a single entity, Alberta Health Services, and nobody knew the next day who was actually accountable for what,” said Kendel.
Julie Ali · 

This is a good move on the part of the government of Saskatchewan so long as it avoids the problems that we have encountered as citizens in Alberta. Some of these problems include the following:

1) No accountability.
We can't determine who is responsible for anything at Alberta Health Services (AHS-our regional health authority).
We don't have an external appeal process for problems that come up that can't be resolved in the ordinary way and we can't get any accountability for the results of the internal to AHS appeal process. This appeal process was only put in recently despite a requirement for an appeal process in the Nursing Act.
The troubling lack of acccountability means that patients and their families have to provide oversight for their care. Eg. My handicapped sister is in the continuing care system. I have a team of folks who work with her. Who is ultimately responsible for her care? I would say it is the family.

2) No transparency.
Problems in the system are not revealed to us. The CCHSS and Quality Audits for continuing care facilities are not available on a website; we have accommodation reports up for a while and then they come down. No permanent respository exists for these audits. No adverse event repository that I can determine. Fatality reports are simply extra paper and the folks in the government of Alberta are not required to implement any of the fatality report recommendations.

3) Waste of money
The PCs were incredibly wasteful in terms of the money spent on the individual CEOs and executive staff--of the former multiple health authorities. When these health authorities were consolidated they wasted a ton of money to pay severance.

Now we have one health authority (AHS) and a mysterious second health authority (Covenant Health). The role of Covenant Health is apparently that of a private contractor but we pay for the upgrades, renovations and expansion of their facilities. It's frankly not very fiscally sound to do this sort of corporate welfare when we don't end up with public assets. We also provide 50% of the infrastructure costs to real estate developers to make continuing care facilities in the form of ASLI grants. These assets are not owned by the citizens and we also get stuck providing staff, ongoing maintenance costs as well as renovation costs. Health care costs at these facilities-mainly supportive living are also covered. The rigged free market for the continuing care system in Alberta with the expensive executive costs at both AHS and Covenant Health are seen as acceptable costs by the GOA.

I don't find these acceptable costs but government does what it wants to do with our money. Meanwhile executive staff at both AHS and Covenant Health are making a ton of money for no deliverables that I can determine.

4) No performance
Frankly I see a system with few deliverables in Alberta. The mental health system is a mess with poor access for all citizens. There are no mental health beds for kids in crisis that I can determine. Services for citizens with disabilities is abysmal. I was told that there was no complex care in Alberta and that I was asking for Utopian service just to get folks to check on my sister hourly during the night. So ridiculous. If the system can't even set up a surveillance system for use of a BIPAP machine what the heck is this system able to do?

5) Poor treatment of handicapped citizens.
My handicapped sister was subject to a do not resuscitate order (DNR) at the Grey Nuns Hospital in Edmonton for 4 years. This is despite the fact that she has a resusciate order on file. Apparently the doctors in Alberta can now overrule patient wishes. My sister is alive today but without strong advocacy a patient in such a situation is very vulnerable.

6) There is no way to change the mess in the system
Everyone is basically guarding their turf and making money. While the amalgamation of the system might make the losses to citizens less, the elite always make their cash and benefit excessively without having to provide performance. It's troubling but there you go. It is what it is. We just have to watch the money vanish on the topdogs while citizens suffer.
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