Alberta Health Services


Alberta Health Services is the single health authority for the Canadian province of Alberta.
Alberta Health Services delivers medical care on behalf of the Government of Alberta's Ministry of Health through 400 facilities throughout the province, including hospitals, clinics, continuing care facilities, mental health facilities and community health sites, while providing a variety of programs and services.
AHS is the largest single health authority in Canada and is the largest employer in the province of Alberta as well as being the fifth largest single employer in Canada.
Alberta Health Services is headquartered in Edmonton, Alberta.

Overview

According to the December 31, 2019 Ernst & Young review of AHS performance commissioned by Alberta Health, Alberta has Canada's "largest integrated provincial health care system". AHS serves 4.3 Million Albertans and has a staff of 125,000 staff and 10,000 physicians. Ernst & Young said that AHS was "one of Canada's top 100 employers." AHS foundations raise over $250 million annually.

History

From 1992 to 2000, Alberta's Conservative Premier Ralph Klein's oversaw deep cuts to provincial health as part of his focus on eliminating Alberta's deficit. Klein replaced hundreds of local boards of directors of hospitals, long-term care and public health services, with 17 health authorities based on geographic regions. He also created provincial health authorities for cancer, mental health and addiction services. Per capita spending on health was cut from CA $1,393 in 1992 to $1,156 in 1995. At the same time, Klein eliminated or reduced hours for 14,753 positions in health care. Three downtown hospitals were closed by the Calgary Regional Health Authority—one of the hospitals was leased to an American for-profit health group" and the old "Calgary General Hospital was blown up in October 1998". This left many Calgarians "without access to emergency care in the downtown core." The "controlled implosion of Calgary General Hospital"—the Big Bang—was described as the "dawn of a regionalized, integrated healthcare system in Alberta."
The Alberta Health Services, which was established on May 15, 2008, is a quasi-independent agency of the Alberta government with a mandate to public health services throughout the province.
Ed Stelmach, who served as Alberta's premier from December 2006 to October 2011, as leader of the Progressive Conservative Association of Alberta, introduced major reforms to Alberta's health-care system. On May 15, 2008, Health Minister Ron Liepert announced that as of April 1, 2009, one provincial governance board—the Alberta Health Services Board—would consolidate the "$13-billion-a-year system into one public corporation", replacing Alberta's nine regional health authority boards— Aspen Health Region, Calgary Health Region, Capital Health Region, Chinook Health Region, David Thompson Health Region, East Central Health Region, Northern Lights Health Region, Palliser Health Region, and Peace Country Health Region.
On April 1, 2009, the Health Governance Transition Amendment Act dissolved the Alberta Mental Health Board, the Alberta Cancer Board and the Alberta Alcohol and Drug Abuse Commission, and completed the transition to Alberta Health Services.
Prior to these changes, health services in Alberta had undergone several governance reorganization which had resulted in fewer separate public organizational entities, in 1996, 2003, and 2006.
The Ernst & Young December 2019 review said that the AHS could save "up to $1.9 billion annually". The NDP opposition called the UCP's proposed changes to AHS, the "Americanization of AHS."

Mission and organization

AHS provides health services to some patients in British Columbia, Saskatchewan, and the Northwest Territories, as well as to over 4.3 million Albertans.
Alberta Health Services has articulated three broad goals which expand into eight 'areas of focus' and 20 strategic priorities.
Alberta Health Services has been organized so as to separate acute hospital facilities from smaller hospitals and community services, the latter of which are organized into five zones. The Calgary Zone, for example, includes some sites and services formerly administered by the Calgary Health Region while other services have been reorganized on a provincial scale.

Governance

The organization was initially overseen by a board of directors, followed by an official administrator, and most recently, again by a board of directors. The Alberta Health Services Board reports to the Minister of Health.
Stephen Duckett was the inaugural president and chief executive officer of the newly created health "superboard", Alberta Health Services, and served from the spring of 2009 until November 2010, when then-provincial Health Minister Gene Zwozdesky asked him to resign. Significant budget cuts—of about CA $1 billion—were imposed on AHS by Premier Stelmach, soon after Duckett's appointment.
Chris Eagle served as AHS CEO from November 23, 2010, until October 17, 2013.
On June 12, 2013, Minister of Health Fred Horne fired the entire AHS Board over its refusal to cancel executive bonuses. Three days later, Janet Davidson was appointed the AHS official administrator by Minister Horne to act in place of its board of directors. On September 12, 2013, John W. F. Cowell replaced Davidson as the official administrator. AHS has subsequently had Carl Amrhein and David Carpenter as official administrators.
Vickie Kaminski served from May 2014 until her resignation in late 2015.
The Alberta Health Services Board has been re-introduced, effective November 27, 2015 with Linda Hughes appointed as the board chair.
On June 3, 2016, Verna Yiu became CEO.
In 2020, David Weyant, QC served as Board Chair, Brenda Hemmelgarn as Vice-Chair, and Brian Vaasjo, David Carpenter, Glenda Yeates, Heidi Overguard, Hugh D. Sommerville, Richard Dicerni, and Stephen Mandel, serve as board members.

Employees

By 2018, Alberta Health Services employs over 108,000 staff and more than 7,700 physicians, including clinical, administrative and support personnel across the province. Staff belong to a variety of professional organizations and associations, including United Nurses of Alberta, several locals of the Alberta Union of Provincial Employees, and the Health Sciences Association of Alberta.

Facilities

By 2010, AHS was maintaining and running a number of different types of facilities and services. These included Cancer care for the prevention, detection, treatment, education and care of cancer patients, as well as to facilitate research of cancer; continuing and long-term care
for the treatment of patients with complex health needs requiring 24-hour on-site services from registered nurses; emergency for immediate care of patients with all types of conditions; hospitals for medical, surgical, or psychiatric care of the sick and injured. There were also laboratories for the processing of medical samples and tests; mental health and addictions services for treatment and care of patients diagnosed with mental health or addiction issues and emergency medical services.
AHS is directly responsible for both ground and air ambulance operations in the province, provided through a mix of both direct delivery and contracted providers.
A wider array of miscellaneous health facilities include physiotherapy, occupational therapy, home care, hemodialysis and others, and also include Public Health Centres which provide services such as prenatal, postpartum, health promotion/disease and injury prevention, bereavement services, communicable disease and school health. They also fund affordable housing for seniors at facilities, such as Silvera for Seniors.
Urgent care services include treating patients with unexpected but not life-threatening issues requiring same day treatment.
AHS also operates X-ray and imaging clinics for procedures such as MRIs, X-rays and other types of scans.

Laboratories

In the early 1990s, most of Edmonton's hospital labs were privatized. The Edmonton regional health authority had a 15-year contract with the private company Dynalife, which was ending in the early 2010s.
The provincial government ordered regional health authorities to cut lab spending, which resulted in more public laboratories being established by 2005.
By 2006, all of the lab services in Calgary were under public control.
In December 2013, Alberta Health Services proceeded with "its plan to privatize all of its diagnostic lab services in Edmonton". AHS sent out request for proposals for a "private provider to establish a single $3 billion lab for the Edmonton Zone." By October 16, 2014, Australia's Sonic Healthcare, a private company, had been selected. They would have replaced "hospital labs operated by AHS and Covenant Health, as well as the services now provided by the private company Dynalife." When the NDP won the 2015 Alberta general election, the contract with Sonic was cancelled.
By 2016, the largest medical testing facility in northern Alberta was the a central laboratory facility owned and operated by a private company in Edmonton, Dynalife. As of January 23, 2016, DynaLIFE Dx was owned by Toronto-headquartered LifeLabs and the Burlington, North Carolina-headquartered LabCorp, or Laboratory Corporation of America Holdings, which operates one of the largest clinical laboratory networks in the world. LabCorp had acquired all outstanding shares of Canadian medical laboratory services company Dynacare Inc. for $480 million in May 2002.
In August 2016, Elisabeth Ballermann, then-President of the Health Sciences Association of Alberta, which represented 1,600 lab workers in both the private and public sector, said that HSAA members had "long wanted lab services delivered by the public system". Ballerman said she was convinced, they could "do high quality, world-class work in the public sector. She expressed concern"that under the contract, the new facility to house the Edmonton lab would be owned by a private company, not by Albertans."
In April 2016, then-Premier Rachel Notley, leader of the Alberta New Democratic Party, announced that the Alberta New Democratic Party government was beginning the process of taking over testing done by Dynacare as part of the NDP's campaign promises during the 2015 Alberta general election, to "bring medical lab services under greater public control."
The newly elected United Conservative Party government's Health Minister Tyler Shandro, cancelled the construction of a new super-lab—a "$595-million centralized public lab facility next to the University of Alberta’s south campus". Shandro also exited the "planned $50-million buyout of private lab services company Dynalife by 2022", saying that he disagreed with the NDP's decision to "nationalize Dynalife – to nationalize laboratory services in Alberta.”
On October 24, 2019, under Health Minister Shandro, Alberta's consolidated laboratory services previously provided by multiple organizations in Alberta under the newly named Alberta Precision Laboratories Ltd, a wholly owned subsidiary of AHS, with Tammy Hofer as Chief Operating Officer and Dr. Carolyn O’Hara as Chief Medical Laboratory Officer. Prior to consolidation and during the transition period, laboratory services were provided to AHS through Calgary Lab Services, Covenant Health—the largest Catholic health-care provider in Canada, DynaLIFE, Laboratory Services, Medicine Hat & Brooks Collection Sites, and Lamont Health Care Centre.
As of October 2019, APL continued to "work collaboratively with DynaLIFE, under contract to provide lab services in Alberta." By November 30, 2019, the union that represents public laboratory workers expressed concern that 850 jobs in the public labs, could be lost, after Minister Shandro and APL sent out a Request for Expression of Interest, "to gauge market interest from private third parties for the provision of community lab services in Alberta" as part of their investigation into "new service delivery models."
AHS testing services include AHS Lab Services, Genetic Lab Services, ProvLab, Calgary Laboratory Services, and DynaLIFE Medical Labs.
ProvLab, which "operates under Alberta Health Services Laboratory Services" and has "been in existence for over 100 years", was renamed Public Health Laboratories. It is based in Calgary's Foothills Medical Centre and Edmonton's University of Alberta Hospital in Edmonton. Its focus on "public health and specialized microbiology" including "surveillance, research, specialized laboratory testing and outbreak and emerging infectious diseases response."
During the COVID-19 pandemic in Alberta, Alberta Precision Laboratories, a wholly owned subsidiary of AHS, undertook testing for the virus.
Clinical Support Services and CancerControl Alberta report directly to AHS President and CEO, Dr. Verna Yiu.

South Zone

The south zone includes major centres such as Lethbridge and Medicine Hat serving approximately 300,000 Albertans.
A large network of hospitals is maintained in the outlying communities of Alberta. South Zone includes
South zone hospitals include Big Country Health Centre, Bassano Health Centre, Bow Island Health Centre, Brooks Health Centre, Cardston Health Centre, Chinook Regional Hospital, Coaldale Health Centre, Crowsnest Pass Health Centre, Fort Macleod Health Centre, Medicine Hat Regional Hospital, Milk River Health Centre, Piiyami Health Centre, Pincher Creek Health Centre, Raymond Health Centre, and Taber Health Centre.

Calgary Zone

The Calgary Zone administrative offices are located in the Southland Park business complex. Calgary Zone comprises territory formerly administered by the former Calgary Health Region and includes five major acute care sites including Foothills Medical Centre, Peter Lougheed Centre, Rockyview General Hospital, South Health Campus, and Alberta Children's Hospital. Serving approximately 1,400,000 Albertans.
A large network of hospitals are maintained in the outlying communities of Alberta. Calgary Zone includes Canmore General Hospital, Claresholm General Hospital, Didsbury District Health Services, High River General Hospital, Strathmore District Health Services, and Vulcan Community Health Centre.

Central Zone

The central zone includes major centres such as Red Deer. Serving approximately 450,000 Albertans.
A large network of hospitals are maintained in the outlying communities of Alberta. Central Zone includes
Serving approximately 1.3 million Albertans, the Edmonton Zone administrative offices are located in Seventh Street Plaza. The Edmonton Zone comprises territory formerly administered by the Capital Health Region and includes eight acute care sites in the metropolitan area, which include.
The north zone includes major centres such as Grande Prairie and Fort McMurray. Serving approximately 450,000 Albertans.
A large network of hospitals are maintained in the outlying communities of Alberta. North Zone includes
A large network of hospitals are maintained in the outlying communities of Alberta. They include
In addition to providing acute care, Alberta Health Services took over responsibility for all emergency medical services from municipalities on April 1, 2009, making ground ambulances a responsibility of the provincial government.
Provincial air ambulance transitioned to AHS in April 2010. Also included in the provincial model of EMS are inter-facility hospital transfers, and EMS dispatch.
In 2013, EMS averaged about 370,000 ambulance responses annually, with approximately 30% of these being patient transfers between health care facilities, and 70% being emergency responses.
EMS is provided through a hybrid of direct delivery and contracted services. In 2013 this hybrid consisted of 204 ground ambulance locations. Practitioners include approximately 3,000 paramedics, emergency medical technicians and emergency medical responders.
There are 550 ambulances throughout the province, including 278 owned and operated by AHS.
In addition to land-based ambulances, AHS contracts 12 fixed-wing aircraft to provide 24-hour air ambulance services throughout the province. 5,500 patients were transferred by fixed-wing aircraft via contracted air ambulance providers in Alberta in 2010.

Comparison with other provinces

In general, Alberta, which has been the province with the highest GDP for decades, spends more money on public services, including on health, than any other Canadian province. According to a 2019 report, health care accounts for about 43% of the public expenditures in the province.