Delivering Investments Through Capital Contributions – The First Nations and Inuit Health Branch, Health Canada Experience FMI Panel Discussion on Infrastructure and Third Party Delivery Crowne Plaza, Gatineau, QC January 19, 2017

Objectives Provide some context on Health Canada’s Health Facilities Program (HFP) Outline some aspects of the approach taken to delivering new time-limited infrastructure investment funding

The HFP Operating Context The HFP administers contribution agreements that provide First Nations living on reserve with appropriate space to safely and efficiently deliver health programs and services in their communities. Program funding supports a portfolio of approximately 840 buildings, including 379 health facilities, 213 residences and 4 hospital complexes across Canada, excluding BC. Capital investments have historically been funded through a dedicated annual appropriation of approximately $23M. (SIF $81M +$13M) Health Canada has no ownership or other legal interest in capital assets funded through the HFP.

The HFP Business Context The HFP is delivered by HC’s First Nations and Inuit Health Branch (FNIHB) headquarters and regional offices, in collaboration with HC’s Corporate Services Branch as a real property partner. Historically, demand for HFP funding has always exceeded available resources - translating funding requests into a rank order of need is a key business process. Investment planning process centres on developing and maintaining a national long term capital plan, and maintaining a prioritized listing of unfunded capital projects that can be accessed in the event that additional capital resources are made available.

Planning for the delivery of new investment initiatives Relying on existing business processes provides a level of confidence in the underlying management control framework guiding investment planning and contributions management activities. New initiatives present several challenges: Internal capacity threshold for managing increased work volume Incorporating new / additional monitoring and reporting requirements Contingency actions in event a project cannot proceed Having an accurate assessment of a program’s risk profile is key for successful results. Logistics No direct control over project delivery Cost & schedule targets