Tuesday, April 18, 2017

Province of Alberta The 27th Legislature Second Session Alberta Hansard Thursday, March 12, 2009 Issue 14 The Honourable Kenneth R. Kowalski, Speaker------The Speaker: The hon. Member for Edmonton-HighlandsNorwood. Long-term Care Mr. Mason: Thank you very much, Mr. Speaker. Today there is a crisis in our province’s hospitals. Emergency rooms are overcrowded, sometimes dangerously so. With no long-term care beds available over a thousand patients wait in hallways, supply closets, and expensive acute care beds. Worse, seniors are being moved from long-term care beds to private supportive living facilities that they cannot afford and are inappropriate for their needs. This government promised to invest $300 million to create 600 new longterm care beds to help these patients, and this government broke that promise. Not only are few spaces available, but our Auditor General has found that their staff are underpaid and overworked. As a result vulnerable seniors have again and again been left unfed, untoileted, and unbathed because there are simply too few health care workers to handle everyone. Front-line personnel report that because of the short-staffing they fear for the safety of residents. Hiring and training staff in this critical sector would raise standards to an acceptable level and create good jobs in a time of rising unemployment. The government charges its critics in this issue with wanting to institutionalize people. This is false. We want sufficient long-term care beds available but only for those who require them. This government has so far failed to provide these. Mr. Speaker, unless this government lives up to its commitment to our seniors, long-term care facilities will still be bursting at the seams while hospital emergency rooms remain packed and in crisis. Meanwhile, our seniors wait on long lists for basic health services they need while this government continues along its path of broken promises. Once again everyday Albertans are raising their voices and waiting for the government to solve the problem, but the government is not listening. Thank you, Mr. Speaker.----------The goal of the continuing care strategy is to “encourage non-profit and private investment in the development and operation of long-term care facilities.” ------------In a media release issued after Budget 2017 was tabled in the Legislature, the ACCA stated “…the NDP government continues to pay the province’s continuing care industry lip service.” It goes on to state “…our grandparents have been neglected much longer than our province’s recent recession, and, for now, will continue to be forgotten.--------------Alberta Associate Health Minister Brandy Payne says four nurse practitioner projects involving mobile bus units will focus on aiding Albertans with higher medical needs. Boyle McCauley Health Centre, The Alex Community Health Centre, Pure North S’Energy and CUPS will receive a total of $10 million over three years split between the four groups. This will give nurse practitioners the opportunity to work with both registered and licensed practical nurses.-------------Tim Caulfield, director of research for the University of Alberta's Health Law Institute, said if the government had consulted him on whether the Pure North program should be funded, "I would clearly say no. "I don't think there is any evidence to support, for example, the high doses of vitamin D," he said. "Yes, there is interesting research going on. But there is no evidence to support the funding of this kind of level for this kind of service."---------------Although Pure North targets vulnerable people, such as the homeless, who don't have good access to nutritional food, for many years it also offered its program for free to the general population.-------One of those participants agreed to speak with the CBC on the condition of anonymity. The man says he started the Pure North program because he didn't have a family doctor. After a series of blood tests, he was told that his iron levels were too high. Pure North suggested his blood removed in a process called "ferritin reduction." He says he was also put on a program of vitamins and supplements, including a Vitamin D booster of 50,000 international units of Vitamin D every other day for a several days. That's more than 50 times the Health Canada recommended daily allowance. When the man did get a family doctor, he says he was told his Vitamin D levels were too high and that there was no evidence his iron levels were high. After finding this out, KT stopped the ferritin reduction and ended his participation in Pure North. He says he doesn't believe the program did him any harm, but doesn't think it did any good, either. "I didn't really know what the purpose of the program ever was."---------------Pure North has partnered with a number of social agencies in Calgary, including by offering the dental clinic for the homeless at The Mustard Seed. "What you would think is that Mustard Seed is now providing dental services to all of its clients. That's not the case," said Tom Mannix, who was a caseworker there until earlier this year. "The only people that can actually access that clinic have to be part of the Pure North program."------------Mannix said the dental work should be no strings attached. "What I would appreciate is if [Markin] would come into The Mustard Seed shelter, or any shelter for that matter, and just say, 'Alright guys or girls, who here needs dental work done? I have a facility that's located in the basement of The Mustard Seed, you guys are in obvious need and I have a ton of money and I want to be able to help you out.'" Mannix said he understands that many people feel ignored for by the traditional health-care system, but that doesn't ease his concerns about Pure North. "[The clients] are very vulnerable and they're easy to take advantage of, is my concern," he said. "I don't know what they're doing with the [blood] samples. [Pure North's] consent is very long and extensive and a lot of the folks that we work with, they don't have a lot of education ... Some of them have literacy issues and have no idea what they're signing up for." Mannix also said that, when The Mustard Seed was serving lunches, he saw a nurse from Pure North strongly encouraging each person to to take Vitamin D with their meal — upwards of 20 drops directly on the food, he said. "Almost, 'Would you like salt and pepper and have a little Vitamin D with that?' " Some would have known what they were taking because of information sessions, but others probably didn't know what Vitamin D was.-------Tim Caulfield, the Canada Research Chair in Health Law and Policy at the University of Alberta, says the bar is very high when it comes to public funding of health care. "When you're actually trying to get dollars from the government, you do have to provide evidence of efficacy. Best case scenario is a randomized, double blind, controlled study, where you really get a sense 'does this work.' And often times, one isn't enough," says Caulfield. "You have to remember often times this stuff doesn't work."--------------Cheesepoof Popular snake oil is still snake oil. Provide peer-reviewed studies of methodology before providing any form of public funding.


March 12, 2009----Mr. Mason: Thank you very much, Mr. Speaker. Today there is a crisis in our province’s hospitals. Emergency rooms are overcrowded, sometimes dangerously so. With no long-term care beds available over a thousand patients wait in hallways, supply closets, and expensive acute care beds. Worse, seniors are being moved from long-term care beds to private supportive living facilities that they cannot afford and are inappropriate for their needs. This government promised to invest $300 million to create 600 new longterm care beds to help these patients, and this government broke that promise. Not only are few spaces available, but our Auditor General has found that their staff are underpaid and overworked. As a result vulnerable seniors have again and again been left unfed, untoileted, and unbathed because there are simply too few health care workers to handle everyone. Front-line personnel report that because of the short-staffing they fear for the safety of residents. Hiring and training staff in this critical sector would raise standards to an acceptable level and create good jobs in a time of rising unemployment. The government charges its critics in this issue with wanting to institutionalize people. This is false. We want sufficient long-term care beds available but only for those who require them. This government has so far failed to provide these. Mr. Speaker, unless this government lives up to its commitment to our seniors, long-term care facilities will still be bursting at the seams while hospital emergency rooms remain packed and in crisis. Meanwhile, our seniors wait on long lists for basic health services they need while this government continues along its path of broken promises. Once again everyday Albertans are raising their voices and waiting for the government to solve the problem, but the government is not listening. Thank you, Mr. Speaker.

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I put down the words
as witness documents
to the failure of government

and I told the stories
of the most defenceless citizens
that the government ignored

I watched the mouths open and close
at the factories of spin
and the successive health ministers intone

that abuse would not be tolerated
while they failed to do
the work of oversight

I listened to the good news of 2.2% funding increasing
for the costs of carbon tax work in the continuing care system
and I wonder to myself at the farce of governance

where are the funds for the increase in the numbers of staff?
where are the funds for training the staff?
and where are the funds for the supports and services of residents?

it's all spin
and yet for the odd projects at Alberta Health
we see $14.2 million of our taxpayer dollars given out

like pocket change to the foundations of oil men in Alberta
what sort of decision tree exists in government
to ensure that this money is well spent?


I write the words down every day
and I speak for the most vulnerable seniors in care
of the government of Alberta

http://www.assembly.ab.ca/ISYS/LADDAR_files/docs/hansards/han/legislature_27/session_2/20090312_1330_01_han.pdf
Province of Alberta
The 27th Legislature
Second Session
Alberta Hansard
Thursday, March 12, 2009
Issue 14
The Honourable Kenneth R. Kowalski, Speaker

The Speaker: The hon. Member for Lethbridge-East, followed by the hon. Member for Leduc-Beaumont-Devon. Long-term Care for Rural Seniors

Ms Pastoor: Thank you, Mr. Speaker. The minister of health dodged my questions regarding the future of long-term care for seniors in rural Alberta. The minister says: wait for the budget. However, hundreds of seniors are at home or in acute-care beds waiting to get into long-term care placement. To the Minister of Health and Wellness: again, what commitment is the minister willing to make to rural seniors so that when they need long-term care, they will not be moved from their family and community?
Mr. Liepert: Well, Mr. Speaker, there hasn’t been any dodge in anything. I’ve been very clear in this House that what we need to do is a better job of ensuring that our senior patients have the kind and quality of care that best meets their needs. I think that in the budget we will be bringing forward you will see some initiatives so that, hopefully, we can provide care and not necessarily just provide facilities that we have to have seniors move out of their community to reside in. The Speaker: The hon. member.

2:10 Ms Pastoor: Thank you, Mr. Speaker. The goal of the continuing care strategy is to “encourage non-profit and private investment in the development and operation of long-term care facilities.” Will the minister include a provision so that a percentage of those encouraged facilities will be in rural Alberta?

Mr. Liepert: One of the options that we’re looking at, Mr. Speaker, is working with the nonprofit and private sectors to say: how can we together have the facilities, whether they’re long-term care, whether they’re assisted living, daily assisted living, or designated assisted living, where it meets the need? I would suggest that there’s really no differentiation between rural, urban, Edmonton, Calgary, Lethbridge. We need to have the facilities where the need is.

Ms Pastoor: Well, Mr. Minister, there really is a huge need in the rural area. My next question would be to the Minister of Seniors and Community Supports. Helping seniors, especially rural seniors, stay in their communities is an integral part of the continuing care strategy. In the 2007-2008 annual report rural affordable supportive living was unspent by $3.7 million. Could the minister explain why? 

Mrs. Jablonski: Mr. Speaker, I certainly agree with the member across the way that having assisted living facilities in our rural areas is very important, and we are trying to focus on that. All the money has been appointed. There have been delays in construction, and this is because of delays in receiving permits. The availability of construction personnel delayed the start of construction on some of the projects. It’s necessary to understand that at the beginning of a project we only give out half of the money, and we don’t give the rest of the money until halfway through and at the end of the project.


The Speaker: The hon. Member for Edmonton-HighlandsNorwood. Long-term Care

Mr. Mason: Thank you very much, Mr. Speaker. Today there is a crisis in our province’s hospitals. Emergency rooms are overcrowded, sometimes dangerously so. With no long-term care beds available over a thousand patients wait in hallways, supply closets, and expensive acute care beds. Worse, seniors are being moved from long-term care beds to private supportive living facilities that they cannot afford and are inappropriate for their needs. This government promised to invest $300 million to create 600 new longterm care beds to help these patients, and this government broke that promise. Not only are few spaces available, but our Auditor General has found that their staff are underpaid and overworked. As a result vulnerable seniors have again and again been left unfed, untoileted, and unbathed because there are simply too few health care workers to handle everyone. Front-line personnel report that because of the short-staffing they fear for the safety of residents. Hiring and training staff in this critical sector would raise standards to an acceptable level and create good jobs in a time of rising unemployment. The government charges its critics in this issue with wanting to institutionalize people. This is false. We want sufficient long-term care beds available but only for those who require them. This government has so far failed to provide these. Mr. Speaker, unless this government lives up to its commitment to our seniors, long-term care facilities will still be bursting at the seams while hospital emergency rooms remain packed and in crisis. Meanwhile, our seniors wait on long lists for basic health services they need while this government continues along its path of broken promises. Once again everyday Albertans are raising their voices and waiting for the government to solve the problem, but the government is not listening. Thank you, Mr. Speaker.




http://bccare.ca/2015/10/alberta-continuing-care-association-responds-to-provincial-budget/


Alberta Continuing Care Association Responds to Provincial Budget

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The Alberta Government released its much anticipated 2015 Budget yesterday which included commitments to invest over $210M in public long-term care and home care. According to the budget documents tabled in the Alberta legislature yesterday, the following investments will be made:
  • $120 million over 2 years (starting in 2016-17) for new long-term care spaces
  • $90 million over 2 years (starting in 2016-17) to expand public homecare
tammyleach
Tammy Leach, Executive Director, Alberta Continuing Care Association responds to the 2015 Alberta Budget
While the commitment for new funding was welcomed by Tammy Leach, Executive Director for the the Alberta Continuing Care Association (ACCA), there remains a number of significant concerns within the sector.
“We are also pleased to see the funding for the new long‐term spaces,” said Leach. The budget committed $40 million in 2016‐17 and $80 million in 2017‐18 toward the costs of operating 2,000 new public long‐term care spaces. There were also increasing supports for seniors to support independent living.
Unfortunately, the budget did not address continuing care or the approach to funding for current spaces and services. “After multiple years of funding which has lagged behind costs, many other issues need to be discussed and addressed,” said Leach.
“ACCA wants to work with the government as quickly as we can on two issues which were not addressed in the budget,” said Leach. “The first is the funding for ASLI (the Alberta Supportive Living Initiative) projects carried over from the previous government that are on hold. The second is clarifying the reference to “public” care spaces.
Historically, more than 60% of Alberta’s care is provided by nonprofit, faith‐based and private care providers,” she said. According to recent reports released from the Health Quality Council of Alberta (HQCA), site ownership (public, voluntary, private) has no influence on resident or family experience and all care providers are held to the same standards and regulations.
Many issues need to be addressed to meet the needs of Albertans. “As an industry we are proud of the level of care we provide to seniors and other residents. We are concerned about our ability to sustain that quality,” Leach said.
To read more about the ACCA budget response, please click here.



http://edmontonjournal.com/news/local-news/opinion-major-challenges-ahead-for-continuing-care

Opinion: Major challenges ahead for continuing care

Published on: November 24, 2015 | Last Updated: November 24, 2015 12:35 PM MDT
The number of Albertans needing home care, supportive living or long-term care is going to increase significantly, writes Tammy Leach, CEO of the Alberta Continuing Care Association.
The number of Albertans needing home care, supportive living or long-term care is going to increase significantly, writes Tammy Leach, CEO of the Alberta Continuing Care Association. GAVIN YOUNG / CALGARY HERALD
Early in its mandate, our new NDP government made three major announcements which will address short-term needs within the continuing care system. However, more is needed to ensure the needs of Albertans can be met. We owe it to our seniors and all vulnerable Albertans to understand and prepare for the challenges ahead.
The government’s first commitment was to create 2,000 new long-term care spaces. The second was the confirmation on Oct. 29 of 25 ASLI (Alberta Supportive Living Initiative) projects across the province, which will ultimately add approximately 2,000 beds within the continuing care spectrum. Third, the budget added much-needed money for expansion of home care.
Residents, their families and those who provide supportive living, long-term care and home care welcome these initiatives. The expansion of home care and addition of spaces were needed and will likely reduce the number of chronic care patients occupying acute-care hospital beds.
That’s the good news.
The bad news is that after years of inattention and chronic underfunding, significant issues still need to be addressed. We need a broad public discussion about our expectations and priorities to ensure we get future continuing care right: These are community decisions that ought not to be left entirely to our health bureaucrats, able though they are.
As we enter this discussion, we should focus on the real issues and not waste time on red herrings. For example, recent research by the Health Quality Council of Alberta (HQCA) has confirmed that quality of care is not affected by whether the provider is private, non-profit, faith-based or public, or whether the staff are unionized. There is plenty of evidence that all types of providers are responsible, committed and caring.
On the other hand, the report identified five concerns of families and residents: the need for more staff; timely help and supervision for basic needs; cleaner and better-maintained facilities; access to related services; and quality, varied and nutritious food.
This is a telling list because these concerns are primarily driven by funding and continuing care is falling behind. Current rates of funding are actually below what was received in 2011, after inflation and cost increases are factored in. For the past three years, funding increases for continuing care have been zero, between zero and two per cent, and zero. At the same time, overall health-care funding has increased at six per cent a year.
Just as schools need teachers, funding for spaces has to come with funding for care. In Alberta, continuing care is funded at 19 per cent below the national average. In comparison, acute health care in Alberta gets 33-per-cent more than the national average. Under these conditions, the HQCA conclusion that there has been “no significant change” in quality of continuing care is a credit to the commitment of our care providers.
It’s not just the quantity of funding that needs to be addressed. Our current patchwork system of funding, program models and regulations needs to be revisited. Changes are needed — not to reduce standards, but to allow the system to be more client- and resident-centred, giving providers the flexibility to innovate and respond to the changing needs of clients and residents, and to reflect changes in the scope of practice of our health-care professionals. We need to ask ourselves whether a 30-year-old model of care is acceptable for our loved ones.
The NDP government has taken some initial steps toward getting things back on track, but there is urgency to tackling these issues as quickly as possible. The number of Albertans needing home care, supportive living or long-term care is going to increase significantly. Will we be ready?
Continuing care providers want to work with the government and all Albertans to build the best possible system. The Alberta Continuing Care Association looks forward to working with government as it takes its next steps to strengthen care and supports.
Tammy Leach is CEO of the Alberta Continuing Care Association





http://bccare.ca/2017/03/alberta-care-providers-respond-to-provincial-budget/



Alberta care providers respond to provincial budget

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Late last week the NDP government in Alberta unveiled their 2017 Budget. Although it did include funding for a new 200 bed publicly owned and operated care home in Calgary, the budget triggered a strong reaction from the Alberta Continuing Care Association (ACCA).
In a media release issued after Budget 2017 was tabled in the Legislature, the ACCA stated “…the NDP government continues to pay the province’s continuing care industry lip service.” It goes on to state “…our grandparents have been neglected much longer than our province’s recent recession, and, for now, will continue to be forgotten.”
Tammy Leach, Executive Director for the ACCA states in the news release that “…this budget really misses the mark.” However, Leach does credit the NDP for supporting new investments in home care.  “Recognizing the importance of investments in community care, with an added emphasis on home care, makes sense for Albertans and for a more efficient overall health system.”
The ACCA does reference new investments recently made to support seniors in British Columbia:
Alberta could have followed the lead of our neighbors to the west. On March 9, 2017, the BC Government and its Minister of Health announced significant funding investments in seniors care. $700 million over 4 years for home and community care; contracted providers given funding to allow for an average of 3.36 direct care hours which equates to over 1,500 new front line staff and the BC Care Association was provided with $10 million dollars to assist operators with the purchase of equipment such as wheelchairs and ceiling lifts.
Leach went on to state “…with today’s disappointing announcements, we will simply have to continue to be innovative to strive to sustain the quality care and quality of life our seniors and vulnerable adults deserve.”
About ACCA: ACCA represents a unique alliance of providers in Alberta’s Continuing Care sector. Their members provide care and services for nearly 12,000 long term care (LTC) and designated supportive living (DSL) individuals and over 5.3 million hours of Home Care to Albertans. They champion quality of care, quality of life and enhanced wellness for Albertans requiring Continuing Care. ACCA is a member of the Canadian Association of Long-Term Care (CALTC).


http://www.cbc.ca/news/canada/calgary/pure-north-dental-care-comes-with-strings-caseworker-says-1.2288712



Pure North dental care comes with strings, caseworker says

Preventive health plan offers dental care at The Mustard Seed - but only for Pure North members

CBC News Posted: Oct 30, 2013 3:16 PM MT Last Updated: Oct 30, 2013 3:22 PM MT
Pure North participants are given a regimen
Pure North participants are given a regimen (Katy Anderson/CBC)
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A man who was formerly a caseworker for The Mustard Seed street ministry says he objects to the dental clinic attached to the non-profit because, he says, it only offers dental care to people who are part of the Pure North S'Energy preventive health program.


About 21,000 people in Alberta and B.C. have signed on to the Pure North program, which gives participants a wide variety of high-dose vitamins and supplements, lifestyle counselling and dental care.
The seven-year-old program was founded by energy executive and Calgary Flames part-owner Allan Markin, who funds the program at a cost of $20 to $30 million annually. Pure North is now looking for provincial funding to expand its programs — an investment it says will save the province $500 million a year.


Pure North has partnered with a number of social agencies in Calgary, including by offering the dental clinic for the homeless at The Mustard Seed.
"What you would think is that Mustard Seed is now providing dental services to all of its clients. That's not the case," said Tom Mannix, who was a caseworker there until earlier this year. "The only people that can actually access that clinic have to be part of the Pure North program."
Until recently, all of Pure North's services were free except for some shipping and handling charges. Now "vulnerable populations" such as the homeless and low-income seniors continue to receive the supplements, dental care and counselling for free. Other participants pay on a cost-recovery basis.

Health-care concerns

Mannix said the dental work should be no strings attached.


"What I would appreciate is if [Markin] would come into The Mustard Seed shelter, or any shelter for that matter, and just say, 'Alright guys or girls, who here needs dental work done? I have a facility that's located in the basement of The Mustard Seed, you guys are in obvious need and I have a ton of money and I want to be able to help you out.'"
Mannix said he understands that many people feel ignored for by the traditional health-care system, but that doesn't ease his concerns about Pure North. "[The clients] are very vulnerable and they're easy to take advantage of, is my concern," he said. "I don't know what they're doing with the [blood] samples. [Pure North's] consent is very long and extensive and a lot of the folks that we work with, they don't have a lot of education ... Some of them have literacy issues and have no idea what they're signing up for."  
Mannix also said that, when The Mustard Seed was serving lunches, he saw a nurse from Pure North strongly encouraging each person to to take Vitamin D with their meal — upwards of 20 drops directly on the food, he said.
"Almost, 'Would you like salt and pepper and have a little Vitamin D with that?' "
Some would have known what they were taking because of information sessions, but others probably didn't know what Vitamin D was.
Many participants of Pure North have told CBC News the program has improved their health and sense of well being.



https://albertaventure.com/2014/02/the-legacy-investment/


Meet four Albertans who have put their wealth to interesting use

Read what Allan Markin, David Werklund, Pat Bowlen and Don Taylor each did with their money

Feb 17, 2014

by Alix Kemp

009_legacy_storyimage
Illustration Pete Ryan
We all want to make some kind of a mark on the world. Some of us leave a larger mark than others. Here’s a look at four Albertans who put their millions to use, whether to found their own non-profit, buy a sports team or start a school.

Allan Markin

Former chairman, CNRL; Part-owner, Calgary Flames;
Founder, Pure North S’Energy
The chairman of CNRL until 2012, Allan Markin is well-known for being generous with his millions. Until 2013, he held the record for the largest donation in the history of the University of Calgary when he donated $18 million to the school in 2004. He was one of the founders of St. Mary’s University College, and he’s donated $20 million to that institution over the past 20 years. But Markin’s most notable use of his money might be Pure North S’Energy Foundation, the not-for-profit health organization he established in 2006. Originally meant as a workplace health initiative for CNRL employees, Pure North is a preventive health program that provides vitamin supplements, lifestyle counselling and some dental services to participants. Markin funds the organization himself, aside from some shipping costs covered by participants. Last year, he invested $54 million.
The program has encountered some controversy – it’s largely based in alternative medicine, and encourages participants to take high doses of various vitamins with little evidence of efficacy. That hasn’t stopped Markin from trying to grow the foundation, however. Pure North has been seeking funding from the provincial government to expand its services, and the organization claims that, according to its own research, it could reduce health care costs across the province by $500 million annually.
http://www.cbc.ca/news/canada/calgary/pure-north-health-program-spurs-alternative-public-care-debate-1.2287199

  • Cheesepoof
Popular snake oil is still snake oil.

Provide peer-reviewed studies of methodology before providing any form of public funding.

  • Puppychow
I'm all for preventative medicine being funded by tax payer dollars. But I don't want a penny of my money paying for these purveyors of snake oil!

Pure North health program spurs alternative public care debate

As preventive plan asks province for money to grow, questions arise around what public funds should support

By Judy Aldous, CBC News Posted: Oct 29, 2013 12:26 PM MT Last Updated: Oct 29, 2013 1:07 PM MT
Pure North gives participants a bag of vitamins and supplements. The daily doses are a key part of the program, as well as nutrition  counselling and dental care.
Pure North gives participants a bag of vitamins and supplements. The daily doses are a key part of the program, as well as nutrition counselling and dental care. (Katy Anderson/CBC)
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Over the past seven years, Pure North S'Energy Foundation's preventive health program has gained a significant foothold in Alberta and parts of B.C. — 20,000 people have registered to try its vitamin and supplements, according to the foundation.
But as the charity looks to expand its reach with public funding, there is a growing chorus of criticism over whether the Pure North program is effective and what the role of alternative health care should be in a publicly-funded system.
Pure North S'Energy Foundation was started as a workplace wellness program in 2006 by oil executive and philanthropist Allan Markin, who funds the entire program at a cost of $20 to $30 million annually. Participants receive vitamins and supplements, as well as lifestyle counselling and dental care.
Although Pure North targets vulnerable people, such as the homeless, who don't have good access to nutritional food, for many years it also offered its program for free to the general population.

Sample regimen

Vitamin D booster: 50,000 IU, one capsule every two days for several days.
Multi-nutrients: Up to 2000- 4000 IU of Vitamin D, 310mg Vitamin E, 80 mcg Vitamin K2, 50 mg Vitamin C, more than 30 other vitamins and minerals.
Fish Oils.
Iodine.
Soluble Fibre.
One of those participants agreed to speak with the CBC on the condition of  anonymity. The man says he started the Pure North program because he didn't have a family doctor. After a series of blood tests, he was told that his iron levels were too high. Pure North suggested his blood removed in a process called "ferritin reduction."  
He says he was also put on a program of vitamins and supplements, including a Vitamin D booster of 50,000 international units of Vitamin D every other day for a several days. That's more than 50 times the Health Canada recommended daily allowance.
When the man did get a family doctor, he says he was told his Vitamin D levels were too high and that there was no evidence his iron levels were high. After finding this out, KT stopped the ferritin reduction and ended his participation in Pure North. He says he doesn't believe the program did him any harm, but doesn't think it did any good, either.
"I didn't really know what the purpose of the program ever was."

Alternative medicine questions

Vitamin debate

Most people view vitamins as a sort of insurance policy for an imperfect diet. But there is a growing debate over whether any vitamin supplementation is necessary.
A review was done last year of a series of research studies on the effects of vitamins on both healthy and unhealthy people. It found an increase in risk of death may be linked to beta carotene and Vitamin E, as well as higher doses of Vitamin A.
In the past several years, much research has been focused on Vitamin D, which is a key part of the Pure North S'Energy program. Canadians are often told to take a Vitamin D supplement in the winter months, when we don't get enough time in the sunshine. A study done by New Zealand's Massey University showed Vitamin D improved insulin resistance. Another study showed Vitamin D supplementation can also lower blood pressure of participants during the winter months.
Daily dose
Dr. Paul Offit is the chief of Infectious Diseases at the Children's Hospital of Philadelphia. He has researched the risks of high dose vitamins and written about it in his recent book, Do You Believe in Magic? The Sense and Nonsense of Alternative Medicine.
"If one takes large quantities of excess vitamins, you actually increase your risk of cancer and increase your risk of heart disease," he says.
Offit says there are only a few occasions when we need vitamins.
"You need a Vitamin K shot at birth, if you're breastfeeding a baby, that baby supplements from Vitamin D supplementation until they get a little older," he says.
"Vegans benefit from supplementation from iron or certain or certain B complex vitamin, women of childbearing age should take supplemental Vitamin B9 , which is Folic Acid."
Doctors suggest that another issue with the program is with its trial and error approach to developing the supplement regimen.
National-level speed skater Justin Maunder supports the program, but had some initial problems.
Offered it for free, the athlete's regimen included iodine supplements. Maunder says they affected his thyroid and made him feel groggy and tired and was told if he stayed on it he would have harmed his thyroid. The speed skater stopped taking the iodine and recovered. He remains in the program and says he believes the nutrition counselling has made him a stronger and faster athlete.

Reduced costs

Pure North spokesperson Jack Davis says the foundation thinks that it can help reduce health-care costs in the province by $500 million a year if the program was widely adopted.
"[Markin has] approached the government, not to take over what he's doing, but to work with him on how to make the program accessible to more individuals. We do think that it is the government's responsibility to invest in illness prevention and wellness."
Tim Caulfield, the Canada Research Chair in Health Law and Policy at the University of Alberta, says the bar is very high when it comes to public funding of health care.  
"When you're actually trying to get dollars from the government, you do have to provide evidence of efficacy. Best case scenario is a randomized, double blind, controlled study, where you really get a sense 'does this work.' And often times, one isn't enough," says Caulfield.
"You have to remember often times this stuff doesn't work."

http://www.macleans.ca/society/health/vitamin-determination-an-oilman-becomes-a-health-care-renegade/

Vitamin Determination: An oilman becomes a health care renegade

Allan Markin is one of Alberta’s richest men—and a crusader to get Canadians to take more vitamin D. Misguided eccentric, or visionary?

Jane Macdougall
May 26, 2015
Photograph by Todd Korol
Allan Markin at one of his Pure North preventative health care clinics in Calgary. (Photograph by Todd Korol)
Allan Markin, a retired oil patch executive and one of Alberta’s most prominent philanthropists, shines a flashlight into Jean Pronovost’s mouth. The two men are at a clinic operating out of a former Quality Inn on Calgary’s Macleod Trail that is run by Pure North S’Energy Foundation, which Markin funds.
Minutes earlier Markin and Pronovost had struck up a conversation and found they both had more than a passing interest in hockey. Over the course of two decades, starting in the 1960s, Pronovost had played for the Pittsburgh Penguins, the Washington Capitals, and the Flames (when they were in Atlanta) while Markin remains part-owner of the Calgary Flames. It was after a brief conversation about Pronovost’s career that Markin asks to look into the hockey veteran’s gullet. “No, no, no. Those have got to come out. Immediately,” the former chairman of Canadian Natural Resources says.
Markin believes mercury amalgam fillings are a toxic source of a host of ailments. He excuses himself and returns with Pronovost’s file, telling him that, if he can get to a dental clinic that Pure North runs in downtown Calgary, his mercury fillings can come out right away. Then, as the Pure North team sets Pronovost up with a battery of vitamin supplements, Markin turns to the greater concern he has with Pronovost’s health—one that has transformed Markin from oilman into arguably Canada’s wealthiest and most unorthodox health care renegade. Shaking his head, Markin—who, it should be noted, has no formal medical training—expresses concern about Pronovost’s low vitamin-D level, which was revealed in his blood work.
In Markin’s view, Canadians and their health care system are in peril because of the chronic underconsumption of vitamin D, often referred to as the sunshine vitamin because it’s produced in response to the sun’s UVB exposure. “Every cell in the body needs vitamin D and for most of the year, there’s no way [Canadians] can get enough of it from the sun,” he says. Drawing on widespread, albeit contentious, research, he is convinced the vitamin plays a critical role in offsetting a raft of often deadly, always costly, non-communicable diseases, in addition to promoting overall well-being.
There are a lot of people who, to varying degrees, share Markin’s view on vitamin D, and they run the gamut from respected academics to alternative health care gurus. But none have the financial resources at their disposal, or have been as keen to deploy them, as Markin, whose net worth Canadian Business magazine estimates is more than $600 million. In just the last few years Markin has funnelled an astonishing $200 million into his not-for-profit Pure North S’Energy Foundation, which bills itself as Canada’s largest prevention-focused health care organization. From its top-floor offices in downtown Calgary, the 165-employee foundation operates 40 private clinics across the province, providing nutritional supplements, lifestyle counselling, blood tests and dental care. At last count, Pure North has worked with 40,000 people in Alberta.
But it’s Markin’s crusade to have Health Canada dramatically increase its standard recommended daily intake level of vitamin D—from between 400 to 800 international units (IU) to between 6,000 and 9,000 IU and even as high as 20,000 IU, in some cases—that has brought him national attention. Starting earlier this year, Markin began financing a cross-country awareness campaign, including full-page ads in newspapers. In January, he travelled to Ottawa to lobby officials from Health Canada and the offices of the Prime Minister, the minister of health, and the leader of the Opposition. In March, Markin addressed the House of Commons standing committee on health with his message. “If we can just get Canadians’ vitamin D levels up, we could save $72 billion over the next five years,” he says. “It’s a bargain.”
For Markin, who spent his career in the oil patch focused on the bottom line, the equation is simple—if Canadians follow his advice, he believes close to 40,000 premature deaths could be avoided annually and the health care system saved $14.4 billion. As someone with incredible resources, he has set out to alter Canadian public health care policy. Is he a well-heeled, misguided eccentric? Or is he right?

Photograph by Todd Korol
Having made his millions from oil, Markin is now part-owner of the Calgary Flames. (Photograph by Todd Korol)
Markin’s vast oil wealth traces back to the 1980s when he was running Poco Petroleum and met a young lawyer named Murray Edwards, who is today Canada’s 24th richest person with a net worth of $2.5 billion. Together the two men transformed Canadian Natural Resources (CNRL) from a smudge on the Alberta petroleum landscape into the country’s largest heavy oil producer and second-largest independent natural gas company. By the time Edwards replaced Markin as chairman in the spring of 2012, CNRL was a behemoth with 8,000 employees and revenue of $14.6 billion. Despite rumours of a contentious split, Markin speaks of Edwards tenderly: “He’s as smart as they come,” he says. “For 20 years we spoke with each other at the end of every day. It was like a marriage.”
It was while at CNRL that the building blocks were laid for Markin’s interest in preventative medicine. He observed that productivity was yoked to employee wellness and that the cold, remote oil patch was a notoriously inhospitable work environment. Studies routinely showed that workers drew on counselling services offered by oil companies at a higher rate than other sectors. And so Markin helped develop a health care program for CNRL that came to be regarded as the gold standard in the industry, with lifestyle counselling, nutritional support and comprehensive testing meant to detect health problems early on.
While he was hitting his stride in the oil patch, on a personal level Markin admits his own health was eroding. He winces as he recollects the mysterious pounding headaches that had become a routine part of his day. “Nothing seemed to work so I started taking handfuls of Tylenol and washing them down with scotch. Even that didn’t help much.” Drawing on his observations of CNRL’s employee-wellness program and his own research, Markin became convinced that his headaches were due to his two-dozen mercury fillings and vitamin D deficiency. He had the fillings replaced and upped his vitamin D intake well past the recommended daily allowance. His headaches subsided and he says his sense of general well-being increased significantly.
Whether or not those measures genuinely improved Markin’s health can’t be said for certain. The point is, he believed they did, and wanted to share his experience with others. In 2006 Markin established the Pure North S’Energy Foundation to provide nutritional counselling, dental care and supplements to vulnerable populations, such as low-income seniors, the homeless and people living in remote communities. Its purpose was simple: preventive intervention. Or, as Markin likes to say, “To help people feel better and live longer.”
Pure North isn’t Markin’s only philanthropic venture, with charities and institutions across the province having benefited from his largesse. The donor profile at Calgary’s St. Mary’s University, to which he’s given $20 million, states: “It would difficult to find a citizen of Calgary, or indeed, Alberta, who has not directly benefited from Dr. Markin’s charitable support.” (The honorific reflects honorary doctorates of law he received from three universities.) He’s given tens of millions to programs to promote healthy eating among school children, addiction treatment facilities, education programs and has even assisted a Tibetan resettlement program that aims to bring 1,000 Tibetans to Canada (at no cost to taxpayers). Currently, he supplies the Calgary contingent of Tibetans with the full Pure North program as well as providing housing for several of them at his boyhood home in Bowness, a neighbourhood in Calgary’s west end.
But Pure North is by far the largest recipient of Markin’s charity dollars. In 2013 alone, he donated $50 million to it, with most of the money going to provide Pure North’s vitamin supplements and counselling services free of charge to those who can’t afford them, and on a cost-recovery basis for those who can. Pure North offers a vehicle to promote broader adoption of Markin’s beliefs—that toxins and poor nutrition are causing widespread health problems and that those problems are crippling the Canadian health care system.

social_sells_mac21_4_1024
Markin’s ongoing Vitamin-D campaign boils down to what he and many others see as a five-year old academic flub. In 2010 the Institute of Medicine in the U.S., the health division of the National Academies of Science, released a study jointly commissioned by the U.S. and Canadian governments that set out dietary guidelines for vitamin D. Health Canada’s current recommendation that Canadian children and adults consume between 600 and 800 IU of vitamin D—and no more than 4,000 IU—stems from that report. But critics argue the institute made a statistical error in its interpretation of existing vitamin D studies. Last year, Paul Veugelers, a professor in the school of public health at the University of Alberta, wrote an analysis explaining the error and stating that “the public health and clinical implications of the miscalculated [recommended daily allowance] for vitamin D are serious.” In essence, criticism of Health Canada’s guidelines comes down to body mass. As it stands, the recommendations for vitamin D intake are the same for a slight, nine-year-old girl as they are for a 60-year-old, obese man.
Against the backdrop of the debate over guidelines is an expanding body of research suggesting the value of vitamin D goes beyond our traditional understanding of its importance to skeletal health—that it may have the capacity to reduce cancer cell growth, may play a role in controlling infection, offset cardiovascular disease, as well as reduce the likelihood of developing autoimmune diseases like multiple sclerosis and type 1 diabetes.
Or not. The range of dissent on the subject is dizzying. Where the Harvard Public Health Review goes on record as saying that “certain cancers and immune dysfunctions are strongly associated with vitamin D deficiency,” a recent paper from researchers at the University of Edinburgh questioned even long-held assertions about the vitamin’s role in maintaining bone-mineral density. For researchers like Dr. David Hanley at the University of Calgary, who is currently conducting a clinical trial of vitamin D with a grant from Markin’s Pure North Foundation, more research is needed. For others, like Timothy Caulfield, a professor of health law and science policy at the University of Alberta, and author of Is Gwyneth Paltrow Wrong About Everything?, a recent book debunking celebrity health advice, the debate over vitamin D has left the realm of science altogether. “It’s fascinating. Vitamin D is like a religion,” he says of the palaver. “Evidence doesn’t seem to matter.” Caulfield is equally skeptical about the fiscal impact on our health care system: “There is absolutely no way that someone can make a definitive statement about the health economic impact of vitamin D supplementation. People don’t even agree if supplementation is required for the general population.”
None of this dissuades Allan Markin. He puts his faith in academics like Reinhold Vieth, a professor of nutritional science, laboratory medicine and pathobiology at the University of Toronto and a clinical biochemist at Mount Sinai. Vieth maintains that vitamin D affects every system in the human body and enhances the body’s ability to protect against disease.
More than that is the evidence Markin has witnessed first-hand: “Pure North does longitudinal studies,” where medical data is gathered from individuals over a period of time. “I’ve seen with my own eyes the difference vitamin D makes in people’s lives.”
While the medical jury is still clearly out on vitamin D, Markin continues to devote vast financial resources to the cause. When he appeared before the House standing committee on health in March—where he told MPs that Health Canada was committing an “injustice” by keeping its recommended daily levels so low—he had at least one backer in the room. Liberal MP Hedy Fry, a member of the committee, a physician and the former head of the B.C. Medical Association, says the health agency should overhaul its dietary recommendations. She points to an increase among Aboriginal children of cases of rickets—a disease that leaves bones weakened and prone to deformity—with a rate of the disorder four to five times higher than the national average, and says the dietary shift away from cold-water fish—which is rich in vitamin D—to a more typical Western fare is to blame. (Canada had virtually eradicated rickets at one point, after the introduction of vitamin-D-fortified dairy products in the 1930s.) But unlike the U.S., where Americans can obtain supplements with up to 7,000 IUs of vitamin D over the counter, Health Canada requires a prescription for anything containing more than 1,000 IUs. “Health Canada no longer seems to be guided by scientific or evolving new evidence,” she says.
So far Health Canada has given no indication it will revisit its vitamin D guidelines. It’s an open question as to where this leaves Canada’s wealthiest health care crusader and his Pure North S’Energy Foundation. The collapse in oil prices has shaken the Alberta economy. Any hope he once had that the provincial government might contribute to his preventative health care initiative is likely dashed while the government grapples with massive deficits. In January, Markin posted an open letter to Pure North program participants assuring them that it would not shut down but that the foundation “is currently undergoing a restructuring . . . to be financially sustainable.”
And so, he carries on. Why, exactly? He answers simply: “Because I can. And because it needs doing.” Even if it continues to drain his fortune? “I’ve moved beyond the pursuit of happiness in my life. I strive for peace. And this brings me peace.”

http://www.cbc.ca/news/canada/edmonton/pure-north-unproven-benefits-1.4053866



Alberta rushed $10-million grant, eliminated ethical oversight, for unproven health program

Review found Pure North program could not prove health or economic benefits

By Jennie Russell, Charles Rusnell, CBC News Posted: Apr 04, 2017 5:00 AM MT Last Updated: Apr 04, 2017 5:00 AM MT
Alberta Health determined the alternative health program offered by the private foundation of a Calgary oilman wasn't adequately supported by science and its high doses of supplements could pose a potential health risk — but the government provided a $10-million grant anyway.
Alberta Health determined the alternative health program offered by the private foundation of a Calgary oilman wasn't adequately supported by science and its high doses of supplements could pose a potential health risk — but the government provided a $10-million grant anyway. (CBC)
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Six days before Alberta Health rushed to deliver a $10-million grant to a private alternative-health foundation, the ministry abruptly changed the grant's purpose, eliminating the need for ethics approval for what experts say was a human-subject experiment on thousands of Alberta seniors.
On Dec. 23, 2013, former Progressive Conservative health minister Fred Horne approved the funding to Pure North S'Energy Foundation to expand an unproven, alternative "wellness" program, ultimately to more than 7,300 seniors.
Horne made the decision against the advice of officials from several ministries who had determined the Pure North program was not adequately supported by scientific evidence, could not prove the incredible health and economic benefits it claimed, and could cause adverse health effects in participants. The officials also said no funding should be granted without an ethical review of the entire Pure North program.
"Current research supplied by Pure North is unpublished in peer reviewed medical journals," states an internal Alberta Justice document dated Aug. 28, 2013, less than four months before Horne granted the funding. "It is unclear if the results are clinically significant and lead to better health outcomes."
Horne did not respond to interview requests over the past several weeks.
University of Alberta political scientist Jim Lightbody, an expert in public governance, said there are "tried and true" methods for governments to independently determine whether funding a particular project is valid. That includes substantiating the benefits claimed by the organization requesting funding.
"That is why there are guidelines; that is why there is a competitive process (for funding)," Lightbody said. "And it would seem that there was an end run -  consistently - around any attempt to apply that kind of standard testing to this kind of operation."

Pure North collects health information

Pure North is the private foundation of multi-millionaire Calgary philanthropist Allan Markin, the former chairman of energy giant Canadian Natural Resources Ltd. He declined repeated interview requests from CBC News.
The foundation targets vulnerable populations such as the homeless, addicted, seniors and Indigenous people in such places as homeless shelters and on reserves. Its various health programs offer high-dose vitamins and minerals, lifestyle counselling and, in some cases, treatments to remove heavy metals from participants' blood and mercury-amalgam fillings from their teeth.
None of its alternative treatments are supported by conclusive science.
Pure North collects detailed medical information from its participants, including blood samples, and has built a "mega-database" to which university researchers have been provided access.
The foundation, however, insists it is not conducting research but instead gathers data to gauge the efficacy of its program. Its spokesperson, Stephen Carter, told CBC News the information provided to researchers is simply a "secondary" use of that data.
Carter also claims Pure North has many studies that prove the effectiveness of its program. He said 50,000 people have participated in the program without any safety issues.
Tim Caulfield, director of research for the University of Alberta's Health Law Institute, said if the government had consulted him on whether the Pure North program should be funded, "I would clearly say no.
"I don't think there is any evidence to support, for example, the high doses of vitamin D," he said. "Yes, there is interesting research going on. But there is no evidence to support the funding of this kind of level for this kind of service."

Irregularities in funding agreement process

Thousands of pages of internal government documents obtained by CBC News reveal numerous irregularities in how Alberta Health came to provide the funding to Pure North, including that:
  • For more than a year, the Pure North funding request had been classified, and internally analyzed as a research project. Documents show the research project was supported by then-premier Alison Redford. But the documents contain no explanation for why the ministry abruptly changed the grant's purpose on Dec. 17, six days before Horne signed the funding agreement.
  • The change from health research project to an expansion of Pure North's existing seniors program meant Pure North was not required to obtain independent approval from a research ethics board for its activities.
  • The final grant agreement did not contain any detailed project budget, clear description of the program Pure North would offer to seniors, or specific targets the foundation had to meet.
  • The $10-million grant was inexplicably rushed. "We need to execute it this week," Health chief delivery officer Glenn Monteith told colleagues in a Dec. 17, 2013 email entitled "Urgent meeting." A colleague, Lorraine McKay, issued the directive in an email. "10 million (dollar) grant Pure North - right now. To foundation's efforts to support seniors' initiatives. High level - one year, one time," she said, adding, "bolt in some description material" for the grant.
  • A senior Health official personally walked the ministry's payment request to ATB Financial in downtown Edmonton on Dec. 24, the day after the grant agreement was signed.  
  • Pure North's funding was not "gated" or paid in instalments, based on demonstrable performance measures. Instead, Alberta Health gave Pure North the entire $10 million up front, which some academic researchers say is extraordinary.
  • The documents contain no discussion of the potential liability for the Alberta government should Pure North's program cause any of the adverse health effects senior officials had previously identified. In a review of the Pure North program a year after the program started, Alberta's chief medical officer of health warned of potential liability for the province "should things go wrong."
Pure North spokesperson Stephen Carter acknowledged the request for funding started as a research project, but the focus eventually changed to an established program targeting seniors.
"The Government of Alberta, and Alberta Health in general, isn't interested in funding research projects," Carter said. "They're interested in funding health care for Albertans. So they decided to shift the project and we agreed to shift the project to providing direct health care."
Internal documents, however, show that immediately after Pure North received the funding, Markin began seeking access directly through health minister Fred Horne to anonymized patient data from Alberta Health Services. Markin wanted access to the data so university researchers could assess the efficacy of the recently funded seniors program.
Internal documents show Pure North made repeated requests for funding to the Alberta government, which continued after the NDP assumed power in May 2015.
The program for which Pure North had received the $10-million grant ran for 15 months, ending in March 2015.
As part of the funding agreement, the foundation had to submit both a financial report and a brief progress report every three months. When Pure North submitted its final progress report in late May 2015, it asked for another $4.5 million to continue one part of the program for seniors with special health needs.

"No convincing data" to support claims

In response to the funding request, Alberta Health ordered a review of the Pure North wellness program. Two of three reviewers agreed there was no convincing data to support the claim the program would achieve the health benefits claimed by Pure North. The third reviewer thought a more rigorous review of the program would be needed to either confirm or contradict the foundation's claims.
Two reviewers also raised concerns about the quality of evidence supplied by Pure North. They said much of it was self-reported by participants, there was no evidence any benefits were specifically attributable to the Pure North program, and changes to measures of chronic disease didn't appear large enough to be clinically relevant.
"Placebo effects are very common with nutritional supplements and there are concerns that the program may be overstating the benefits of the supplements, enhancing the placebo effect," a summary of the two reviewers' findings states.
Carter insisted the program was a success. As proof, he cited a study conducted by Herbert Emery of the University of Calgary's School of Public Policy.
Emery's study found participants who stayed in the program for two years significantly reduced their visits to emergency rooms and hospitals, saving the system $276 for each Pure North participant.
But all three independent reviewers found a serious problem with how Pure North calculated savings for the health-care system. They said Pure North told the ministry each client cost the program between $1,280 and $2,300 a year.
When Pure North performed its cost-saving calculations, it "used a cost of $500 per year per client.
"It is unclear how the program could be offered at a dramatically lower cost while maintaining the same results," the reviewers' summary states.
"Based on the absolute reduction in hospital visits (2 per cent), we would need to treat 50 people to avoid a single hospital visit," the review's summary states. "Even using the $500 figure, the program cost would be $25,000 in order to save $1,107 in acute care costs."
Two reviewers said the documentation supplied by Pure North didn't support further investment by the government. The third reviewer couldn't make an evidence-based recommendation but felt a more formal review was warranted "due to the pressing need for community-based health promotion in the province."
NDP Health Minister Sarah Hoffman turned down Pure North's request for further funding of the seniors program based on advice from ministry officials.
In an interview, Hoffman said she had no knowledge of how Pure North came to get the funding from the former Conservative government.
If you have any information about this story, or for another potential story, please contact us in confidence at cbcinvestigates@cbc.ca



http://www.cbc.ca/news/canada/edmonton/pure-north-unproven-benefits-1.4053

Alberta government did not act on warnings about private alternative health program

Documents detail serious health safety incident at Calgary Drop-In Centre

By Jennie Russell, Charles Rusnell, CBC News Posted: Apr 03, 2017 5:30 AM MT Last Updated: Apr 03, 2017 5:30 AM MT
In 2013, Alberta Health Services dietitians warned officials about the potential health safety risks posed by Pure North S’Energy Foundation’s supplement distribution program at the Calgary Drop-In Centre.
In 2013, Alberta Health Services dietitians warned officials about the potential health safety risks posed by Pure North S’Energy Foundation’s supplement distribution program at the Calgary Drop-In Centre. (CBC)



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Charles Rusnell, Jennie Russell
Investigative reporters
Charles Rusnell and Jennie Russell are reporters with CBC Investigates, the award-winning investigative unit of CBC Edmonton. Their journalism in the public interest is widely credited with forcing accountability, transparency and democratic change in Alberta. Send tips in confidence to cbcinvestigates@cbc.ca. @charlesrusnell @jennierussell_

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Nearly six months before Alberta Health gave a private health foundation a $10-million grant, public health dietitians warned Alberta Health Services about a serious potential health risk they believed could have been caused by the foundation's lax distribution of high-dose supplements at the Calgary Drop-In Centre.
The dietitians also warned senior Alberta Health Services (AHS) officials generally about potential health safety risks related to the unproven alternative-health program offered by the Pure North S'Energy Foundation of Calgary, the private foundation of former Canadian Natural Resources Ltd. chairman and Calgary Flames part-owner Allan Markin.
Aart Schuurman Hess
Vancouver food bank CEO Aart Schuurman Hess said he was never told in writing about any potential health risks related to the Pure North program. (CBC)
"Pure North S'Energy is providing these free programs to vulnerable populations such as homeless individuals and senior citizens with limited financial means and who may not have the ability to properly assess the safety of programs being offered," the dietitians wrote in a report circulated to senior AHS officials in early July 2013.
Internal government documents obtained by CBC News contain no reference to AHS acting on these warnings. Nor, it appears, did AHS communicate the dietitians' findings to Alberta Health, the ministry which funds the health authority.
Alberta Health Services did not directly respond to repeated requests for information from CBC News about what, if anything, it did about the health risks identified by its staff at the homeless shelter.
In an interview, Pure North spokesperson Stephen Carter said the foundation was not told about the issue and had no knowledge of it.
Stephen Carter
Pure North spokesperson Stephen Carter acknowledges the foundation made mistakes with its food-bank supplement program. (Sam Martin/CBC)
"We have completed a thorough search of our records," Carter told CBC News in a subsequent letter.
He said someone would have contacted the foundation if the issue "was deemed to be of concern." Despite the concerns of public health officials, Pure North has always pointed to research studies it says show the program is safe and effective.
In December 2013, nearly six months after dietitians reported the potential health safety risks, Alberta Health gave Pure North a $10-million grant to further expand an existing program, which was ultimately offered to more than 7,300 Alberta seniors.
Pure North is a privately run, non-profit foundation that offers an alternative health program involving high doses of supplements, particularly vitamin D. It offers the program at no cost to vulnerable populations such as the homeless, addicted and elderly and for years has delivered its program at various outreach organizations.

Safety issue reported

Internal documents show that on July 2, 2013, Nutrition Services executive director Carlota Basualdo circulated the dietitians' report about Pure North to AHS colleagues.
The dietitians, unnamed in the documents, said they had been approached by provincial health nurses at the Drop-in Centre who had noticed fluctuating INR (International Normalized Ratio) results in the blood tests of clients. INR is a measure of the blood's ability to clot.
They wondered if the fluctuating INR results were caused by "large and inconsistent amounts of vitamins and minerals" being distributed by Pure North at the drop-in centre. They suspected the fluctuating results may be linked to Pure North's distribution of vitamin K, which can affect INR.
Fluctuating INR results can be dangerous in individuals who are at risk of heart attack or stroke because it can make it difficult for a treating physician to regulate the blood's clotting level using drugs such as Warfarin. Too much Warfarin can cause uncontrolled bleeding; too little could result in a heart attack or stroke.
Basualdo's email included a "summary of concerns" prepared by the dietitians, who had conducted an investigation into the supplements, their doses, and how Pure North was distributing them to clients.
Generally, Basualdo said there was concern about "the non-evidence based practice of providing megadoses of vitamins and minerals" above Health Canada's recommended levels, and "the potential adverse effects (fluctuating INR levels due to vitamin K intake)."
The investigation revealed packets of vitamins and minerals, enclosed in a plastic "cellopack," were being distributed daily from a large cardboard box before and after meal times.
Daily dose
Supplements are a key part of the Pure North program, as well as nutrition counselling and dental care. (Katy Anderson/CBC)
"These boxes are often minimally supervised by volunteer staff and individuals have been encouraged to take several packages, to assist with their health," the summary states.
While it is a breach of Health Canada regulations to distribute unlabelled supplements, the summary says: "Each supplement in the package is found unlabelled with no specific instructions on how to take them."

Excessive supplement doses

The dietitians were particularly concerned about Pure North's distribution of high-dose supplements that in some cases far exceeded both Health Canada's recommended dietary allowance (RDA) levels and safe tolerable upper intake levels (UL).
Some supplements were several thousand per cent above RDA levels and some were several hundred per cent above the upper level.
For example, the dietitians discovered Pure North, based on a doctor's written protocol, could have given some clients a vitamin D dose of 50,000 international units (IU) every two days for six days, and then 10,000 IU daily for two months. Health Canada's recommended dietary allowance is 600 to 800 IU and its safe tolerable upper intake level is 4,000 IU.
Vitamin D Recommended Dietary Allowance
A graphic shows the difference between the levels of vitamin D Health Canada recommends, and the levels Pure North recommended in a March 2015 advertising campaign. (CBC)
The dietitians noted a number of health issues that can be caused by excessive doses of vitamin D, including "kidney dysfunction, excess calcium in the urine, soft tissue calcification leading to increased cardiovascular risk," as well as an increased risk of fractures and falls in the elderly.
'I think we may need to prepare for some fallout from this story.'- Jeffrey Johnson, AHS Diabetes, Obesity and Nutrition Strategic Clinical Network
Basualdo sought input from Jeffrey Johnson, scientific director for the AHS Diabetes, Obesity and Nutrition Strategic Clinical Network.
"I think we may need to prepare for some fallout from this story," Johnson said in an email.
"I could imagine some potential malpractice issues, if prescribing high-dose, off-label vitamins and supplements that are negatively affecting patients' health, such as interfering with INR," Johnson wrote. "The evidence base for this is all very weak and speculative in the first place."

'Very serious health consequences'

Basualdo also sought input from Dr. Alun Edwards, senior medical director of the same clinical network as Johnson.
"The potential harm issue would be critical and the issue highlighted of variable INR could have very serious health consequences," Edwards said in an email response to Basualdo. "Vitamin K would be the culprit here."
But another AHS official warned about a potential backlash if they clamped down on Pure North's distribution of supplements.
"Not sure what our purview is in 'drop-in centres' but agree it raises a public health concern," wrote Dr. Leah Gramlich, the provincial medical adviser for nutrition and food services within AHS.
"The flip side is that we might be perceived as the big bad AHS if we remove 'free samples' of multivitamins from a drop-in centre that supports the socially disenfranchised."
There is no mention among thousands of pages of internal government documents of any further action being taken by AHS or Alberta Health about the safety issue.
Jayne Thirsk, director of the Dietitians of Canada, said Alberta health officials need to scrutinize the Pure North program.
"I think as more people become aware of some of the deficiencies in this program and some of the risks in this program, you will see people stepping up and challenging it more and hopefully putting a stop to it," she said.
If you have any information about this story, or for another potential story, please contact us in confidence at cbcinvestigates@cbc.ca


http://www.cbc.ca/news2/interactives/unproven/

INTERACTIVE: Private Health, Public Risk?

http://globalnews.ca/news/3272011/alberta-grant-allows-for-expanded-hours-more-nurse-practitioners-at-health-centres/
February 24, 2017 6:43 pm

Alberta grant allows for expanded hours, more nurse practitioners at health centres

By Ali Kovacevic Global News
Grants have been given to The Alex Community Health Centre to fund multiple nurse practitioner projects for Albertans. It’s a step closer for Albertans to have 'on-the-go' health care.
Grants have been given to The Alex Community Health Centre to fund multiple nurse practitioner projects for Albertans. It’s a step closer for Albertans to have 'on-the-go' health care.
Ali Kovacevic / Global News
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Alberta Associate Health Minister Brandy Payne says four nurse practitioner projects involving mobile bus units will focus on aiding Albertans with higher medical needs.
Boyle McCauley Health Centre, The Alex Community Health Centre, Pure North S’Energy and CUPS will receive a total of $10 million over three years split between the four groups. This will give nurse practitioners the opportunity to work with both registered and licensed practical nurses.

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Alberta’s goal with the Alex buses are to provide “first-stop” medical aid along with ongoing health assistance when needs are high.
With the program underway, CEO of The Alex Community Health Centre Shelly Heartwell said at a Friday event they will offer extended hours for more clients to access their services and open up evening and weekend hours when traditional clinics aren’t available.
“We are excited that these funds are going to open up doors for these programs.”
Heartwell said the funding will provide more hours to potentially hire a mental health therapist, as mental health issues are a big part of the client population at the Alex Health Centre.
“We can provide increased mental health care, addiction supports and systems navigation, allowing us to provide quality care for an increasing population of vulnerable Calgarians,” Heartwell said.
Eric Lavoie, president of the nurse practitioner association of Alberta, said there are roughly 500 licensed nurse practitioners in Alberta to provide assistance on either acute or chronic disease management.
“We are pleased to be working collaboratively,” Lavoie said.
Lavoie acknowledged Albertans want a wide range of care close to home, with services that are cost effective. Both the Alberta Chamber of Commerce and the Municipal association of Alberta are calling for the integration of nurse practitioners across Alberta’s health care system.
“The Nurse Practitioner Association of Alberta is keen to see Albertans benefit from nurse practitioner care across the health-care system,” Lavoie said.


http://www.metronews.ca/news/calgary/2017/02/27/funding-announcement-falls-short-nurse-practitioner-alberta.html

Funding announcement falls short: Nurse Practitioner Association of Alberta

The province announced $10 million in funding on Friday to hire several health care professionals over the next three years

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Eric Lavoie, president of the Nurse Practitioner Association of Alberta, says a new funding announcement from the province is a step in the right direction, but doesn’t go far enough.
CONTRIBUTED
Eric Lavoie, president of the Nurse Practitioner Association of Alberta, says a new funding announcement from the province is a step in the right direction, but doesn’t go far enough.
By: Elizabeth Cameron For Metro Published on Mon Feb 27 2017
The president of the Nurse Practitioner Association of Alberta (NPAA) said a new funding project from the province promising to hire more of the highly-skilled health professionals doesn’t go far enough.
“It’s a step in the right direction, but not the right scale,” Eric Lavoie said.
He was at the Alex Community Health Centre in Calgary on Friday, when the province announced a $10 million, three-year health project that will enable four facilities in Calgary and Edmonton to hire several additional care professionals, including nurse practitioners (NP’s).
NP’s are qualified to diagnose and treat most health concerns, including ordering tests, prescribing medications and performing various procedures.
“The NPAA’s standpoint is that this is a positive step in the right direction, but it’s nowhere near the systemic change that will see Albertans benefit from NP care,” said Lavoie.
He has been calling for a sustainable, province-wide funding model for NP’s for more than a year.
“We would like to see the development of a sustainable funding model for NP to integrate into primary care throughout the province,” Lavoie said.
“Although (this project) is great … they’re only adding about five new NP positions – it falls short of what is required to innovate and remain sustainable.”
Grants have been allocated to The Alex Community Health Centre, Pure North S’Energy, and the Calgary Urban Project Society (CUPS) in Calgary. The Boyle McCauley Health Centre in Edmonton also received funding.
An expert advisory group, led by the Institute for Health Economics, will guide and evaluate the new projects. The results will help form new policies, according to Brandy Payne, Alberta’s associate minister of health.

“We will take what we learn from these projects to make decisions that will protect and improve the primary health care Albertans depend on,” Payne said at the announcement.

http://www.cbc.ca/news/canada/edmonton/carl-amrhein-pure-north-unproven-alberta-1.4068844



CBC INVESTIGATES

Alberta Health deputy minister's relationship with private foundation 'not professional': expert

Carl Amrhein endorsed and participated in Pure North alternative health program

By Jennie Russell, Charles Rusnell, CBC News Posted: Apr 13, 2017 7:00 AM MT Last Updated: Apr 13, 2017 7:00 AM MT
Deputy health minister Carl Amrhein participated in Pure North S’Energy Foundation’s alternative health program.
Deputy health minister Carl Amrhein participated in Pure North S’Energy Foundation’s alternative health program. (CBC)
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Photo of Charles Rusnell, Jennie Russell
Charles Rusnell, Jennie Russell
Investigative reporters
Charles Rusnell and Jennie Russell are reporters with CBC Investigates, the award-winning investigative unit of CBC Edmonton. Their journalism in the public interest is widely credited with forcing accountability, transparency and democratic change in Alberta. Send tips in confidence to cbcinvestigates@cbc.ca. @charlesrusnell @jennierussell_

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Alberta Health deputy minister Carl Amrhein personally endorsed, and participated in, an unproven alternative health program offered by a private foundation that recently received a multimillion-dollar grant that he signed on behalf of the ministry.
A CBC News investigation has uncovered a years-long relationship between Amrhein, the Pure North S'Energy Foundation of Calgary, and its founder Allan Markin that an expert in public governance said was clearly unprofessional.
"The essence of a professional relationship with a client, or with an organization that is seeking money, is called arm's length," University of Alberta political scientist Jim Lightbody said.
"You have a job and you are not, as a public servant — particularly if you are a senior public servant — at the beck and call of some private interest, no matter how well financed," he added.
Jim Lightbody
University of Alberta political scientist Jim Lightbody said the close relationship between health deputy minister Carl Amrhein and Pure North was “not professional.” (CBC)
"This is not a professional relationship," Lightbody said after reviewing internal Alberta Health and University of Alberta documents obtained by CBC News through freedom of information.

Disclosed Pure North participation

Amrhein declined interview requests. But the health ministry issued a statement that simply said: "Amrhein's involvement with Pure North was fully disclosed to the ethics commissioner when he became deputy minister. All records indicate that subsequent decisions regarding funding for Pure North followed the advice of external and departmental experts."
Ethics commissioner Marguerite Trussler told CBC News that when Amrhein became deputy minister in August 2015, he disclosed to her office that he was a participant in Pure North's alternative health program.
But she refused to say whether Amrhein had disclosed anything more about his relationship with the health foundation, saying she was bound by provincial legislation and only had permission from Amrhein to reveal he had disclosed his participation in Pure North's health program.
Trussler said she questioned Amrhein about his signing of an October 2016 grant, worth $4.2 million, for a nurse-practitioner-led clinic for Pure North. She said Amrhein told her the decision was made elsewhere and he merely signed the agreement in his capacity as deputy minister, after the minister had signed off.
The ethics commissioner said her questioning of Amrhein took place "recently." But she could not say whether it was after CBC News published stories on Pure North last week.
Health Minister Sarah Hoffman's press secretary, Tim Wilson, did not respond to questions from CBC News about whether Amrhein had disclosed his prior relationship with Pure North to the minister, and to his senior staff.
Sarah Hoffman
Health Minister Sarah Hoffman refused to say whether deputy minister Carl Amrhein had disclosed his previous relationship with Pure North to her. (CBC)

Deputy minister arranged to have blood drawn

The internal government and university documents detail a close relationship between Amrhein, Markin and Pure North dating back years to when Amrhein was provost of the university, to which Markin was a major donor.
Most disturbing for Lightbody were documents that show Amrhein, while deputy health minister, and his wife planned to become participants in the Pure North program.
Emails from early January 2016 show Markin wanted a personal meeting with Amrhein that would require Amrhein to drive to the Edmonton airport late on a Sunday afternoon.
"The smaller the group the better I think," Amrhein wrote in an email to Wendy Paramchuk, Pure North's executive director, from his official government account. "I assume that the discussion will be high level since I do not manage operating details."  
Amrhein also told Paramchuk he planned to bring his wife to the meeting, hopefully so they could have their blood taken. Pure North collects blood from its participants to determine individual treatment plans, often involving high doses of supplements such as vitamin D.
"We will set up to have our nurse practitioner there to take both your and [your wife's] blood and do a medical intake," Paramchuk replied in an email written the day before the Jan. 3 meeting.
"If possible, if you could both fast for eight hours that would be ideal," Paramchuk continued. "If not, that is okay; we will still take your blood."
"Dear Wendy, okay, I copied [my wife] on this note," Amrhein replied.

Reference letter for Pure North

Pure North is a privately run, non-profit foundation established by Markin that claims it can prevent chronic disease and improve health through its alternative treatments, which include high doses of vitamin D and other supplements and the removal of heavy metals from the body.  
The foundation focuses its work on vulnerable populations such as seniors, the homeless and drug users, and has for years sought a financial partnership with the provincial government. It also funds nutrition and health research at universities.
With donations of more than $20 million, Markin is one of the University of Alberta's biggest donors. Before Amrhein became deputy minister, he was provost at the University of Alberta and documents show he met personally with Markin several times dating back to 2011.
'The essence of a professional relationship with a client, or with an organization that is seeking money, is called arm's length ... this is not a professional relationship.'- Jim Lightbody, political scientist, University of Alberta
In July 2014, as provost, Amrhein wrote a letter of support for Pure North and Markin that lauded the research data — and financial support — Pure North had given his university's academics.
"It has been a privilege to be able to work with Mr. Allan Markin and the Pure North S'Energy Foundation and we look forward to seeing all the program outcomes analyzed in a rigorous manner that meets the highest scientific standards," Amrhein wrote. "If I can supply any further information regarding this outstanding supporter of research, please do not hesitate to contact me directly."
Internal Alberta Health documents show Pure North used Amrhein's letter in September 2014, and again in December 2014, to bolster funding requests to the Progressive Conservative government.

Foundation seeks government funding

In November 2014, Amrhein left the university to become official administrator of Alberta Health Services (AHS). Five days before he left AHS to become deputy minister of health in August 2015, Paramchuk sent an email to two faculty members in the University of Alberta's School of Public Health.
"We have asked the [health] ministry to financially support our program to be delivered to the vulnerable population of Alberta," she wrote in the email.
"This suggestion came from Carl Amrhein," Paramchuk said, and asked the faculty members to review information that Pure North intended to submit to the ministry in support of its funding request.
Duff Conacher of Democracy Watch, a non-partisan watchdog organization, said he believes Amrhein's reference letter in support of Pure North belies bias and creates a potential conflict of interest.
Conacher
Duff Conacher of Democracy Watch said health deputy minister Carl Amrhein should not have been involved in any decisions related to Pure North. (CBC)
"He stated it; that he favours the foundation," Conacher said. "It adds to that conflict of interest if he is actually taking part and receiving the services from the foundation.
"And combined together, I think it clearly crosses the line in both the [provincial Conflicts of Interest] Act and the Code [of conduct for ministers' staff], and he should not have been taking part in any decisions that affected the foundation, that the government was making," he said.
Pure North had previously received public funding. As CBC News reported earlier this month, Alberta Health gave Pure North a $10-million grant in December 2013 to expand its existing seniors program — against the advice of senior ministry officials who said the foundation's alternative treatments were not adequately supported by science and could pose a health risk to participants.
A subsequent review by three independent experts found Pure North couldn't prove its program produced any of the health or economic benefits it claimed.
CBC News also reported that senior Alberta Health Services officials were informed in July 2013 of a serious potential health risk that provincial dietitians believed could have been caused by Pure North's lax distribution of high-dose supplements at the Calgary Drop-In Centre.
When the NDP assumed power in 2015, Health Minister Sarah Hoffman refused, based on advice from her officials, to extend funding to Pure North for its seniors program beyond the $10 million provided by the previous government.

Multi-million-dollar grant agreement

But internal documents show Pure North then began requesting changes to health-care policy that would directly benefit the foundation and further its aims. On several occasions, Markin and Paramchuk communicated directly with Amrhein.
Amrhein directed his staff to research several policy changes requested by Pure North, including making vitamin D an insured drug and allowing nurse practitioners to bill for primary care services provided by the foundation.
None of the policy changes were implemented, although the documents reveal senior ministry officials expended significant resources researching them and dealing directly with Markin. Conacher said Amrhein should not have been involved in any decisions related to Pure North, given his previous support of the foundation.
'He stated it; that he favours the foundation ... it adds to that conflict of interest if he is actually taking part and receiving the services from the foundation.'- Duff Conacher, Democracy Watch
In a Jan. 15, 2016 email, Markin expresses frustration to Amrhein that progress on several policy changes requested by Pure North had been "stymied" by ministry officials.
"As an ally for preventive care, I am calling on you to intervene immediately and send direction to your officials to urgently pursue solutions that will deliver preventive care for our province's most vulnerable citizens," Markin told Amrhein.
Pure North did, however, eventually receive support from the NDP government. In October 2016, Alberta Health finalized a grant agreement — signed by Amrhein — with Pure North to provide the $4.2 million over several years for the nurse-practitioner-led, primary-care clinic in Calgary.
Earlier this month, Hoffman told CBC News she was unaware of any previous public-health safety concerns related to Pure North. She also said the clinic's funding would be jeopardized if it was found to offer any alternative health treatments.
If you have any information about this story, or for another story, please contact us in confidence at cbcinvestigates@cbc.ca.



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