ARCHIVED – Operational Bulletin 373 - December 30, 2011

Excessive Demand Cost Threshold for 2012

This Operational Bulletin has expired.

Summary

The purpose of this Operational Bulletin (OB) is to advise that a new Excessive Demand Cost Threshold took effect December 1, 2011 for use by Health Branch (HB) officers undertaking Immigration Medical Assessments, ensuring that they are fully compliant with the legislation. This OB also establishes a process for regular updating of the Excessive Demand Cost Threshold.

Issue

Updating the Excessive Demand Cost Threshold.

Background

Under paragraph 38(1)(c): “A foreign national is inadmissible on health grounds if their health condition might reasonably be expected to cause excessive demand on health or social services.” Part 1, Division 1 of the Immigration and Refugee Protection Regulations, defines “excessive demand” as:

(a) a demand on health services or social services for which the anticipated costs would likely exceed average Canadian per capita health services and social services costs over a period of five consecutive years immediately following the most recent medical examination required by these Regulations, unless there is evidence that significant costs are likely to be incurred beyond that period, in which case the period is no more than 10 consecutive years; or

(b) a demand on health services or social services that would add to existing waiting lists and would increase the rate of mortality and morbidity in Canada as a result of the denial or delay in the provision of those services to Canadian citizens or permanent residents.

The Canadian Institute for Health Information (CIHI) aggregate that represented average Canadian per capita health expenditure was used as the threshold figure.

In January 2003, a modified approach was implemented by HB, having identified that the CIHI figure did not completely cover expenditures for certain social services, a supplementary amount was identified to account for the missing per capita expenditures. Instructions were issued that this new supplementary amount should be added to the aggregate CIHI figure to arrive at the Excessive Demand Cost Threshold.

This updated threshold of $6,141 is usually multiplied by five (unless the anticipated length of stay is shorter than five years or there is evidence that significant costs are likely to be incurred beyond that period, in which case the period is no more than 10 consecutive years). This results in the legislated threshold of $30,705 taking effect as of December 1, 2011.

As of December 1, 2011, the Regional Medical Officers were advised of the new cost threshold.