Yukon Policy Analysis Case Report
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Yukon Policy Analysis Case Report Canadian Harm Reduction Policy Project (CHARPP) July 2017 1 This research was conducted as part of the Canadian Harm Reduction Policy Project (CHARPP), a mixed-method, multiple-case study drawing on four data sources (policy documents, key informant interviews, media portrayals, and a national public opinion survey) to describe how policies governing harm reduction services are positioned within and across the 13 Canadian provinces and territories. CHARPP is supported by an operating grant from the Canadian Institutes of Health Research. Report Authored by: Jalene Anderson-Baron, School of Public Health, University of Alberta Kamagaju Karekezi, School of Public Health, University of Alberta Jakob Koziel, School of Public Health, University of Alberta Ashley McCurdy, School of Public Health, University of Alberta CHARPP Project Leads T. Cameron Wild, Professor, School of Public Health, University of Alberta (Co-Principal Investigator) Elaine Hyshka, Assistant Professor, School of Public Health, University of Alberta (Co-Principal Investigator) Donald MacPherson, Executive Director, Canadian Drug Policy Coalition (Principal Knowledge User) CHARPP Co-Investigators Mark Asbridge, Associate Professor, Faculty of Medicine, Dalhousie University Lynne Bell-Isle, National Programs Consultant, Canadian AIDS Society Walter Cavalieri, Director, Canadian Harm Reduction Network Carol Strike, Associate Professor, Dalla Lana School of Public Health, University of Toronto Colleen Dell, Professor, School of Public Health, University of Saskatchewan Richard Elliott, Executive Director, Canadian HIV/AIDS Legal Network Andrew Hathaway, Professor, Department of Sociology and Anthropology, University of Guelph Keely McBride, Project Lead, Public Health and Wellness Branch, Alberta Health Bernie Pauly, Scientist, Centre for Addiction Research of BC Kenneth Tupper, Director, Implementation & Partnerships, British Columbia Centre on Substance Use Related citations: Wild, T. C., Pauly, B., Belle-Isle, L., Cavalieri, W., Elliott, R., Strike, C., ... & Hyshka, E. (2017). Canadian harm reduction policies: A comparative content analysis of provincial and territorial documents, 2000–2015. International Journal of Drug Policy, 45, 9-17. 2 Table of Contents 1.0 Overview ................................................................................................................................................. 4 1.1 Contextual Background ....................................................................................................................... 4 1.2 Healthcare Governance ...................................................................................................................... 5 1.3 Substance Use Trends ......................................................................................................................... 5 1.4 Harm Reduction Services in Yukon ..................................................................................................... 6 2.0 Methods .................................................................................................................................................. 8 2.1 Search Process .................................................................................................................................... 8 2.2 Inductive Analysis................................................................................................................................ 9 2.3 Deductive Analysis .............................................................................................................................. 9 3.0 Documents Retrieved ........................................................................................................................... 10 4.0 Results: Inductive Analysis of Documents ……………………………………………………………………………………... 10 5.0 Results: Deductive Analysis of Current Documents (Policy Report Card) ............................................ 11 Table 3: Proportion of policy quality indicators endorsed for all documents within cases ................... 12 6.0 Conclusion ............................................................................................................................................. 13 Appendix A: Systematic search strategy flow diagram ........................................................................... 14 Appendix B: Standard methodology for generating provincial/territorial case report .......................... 15 References ………………………………………………………………………………………………………………………………………….. 18 3 1.0 Overview This document provides a descriptive and analytical account of Yukon’s provincial harm reduction policy context. The study sought to identify provincial-level harm reduction documents produced between 2000 and 2015, however, no such documents were found for Yukon. This account is part of the Canadian Harm Reduction Policy Project (CHARPP), a multimethod multiple case study comparing provincial/territorial harm reduction policies across Canada. The results reported in this document will be summarized and integrated into a national-level report that outlines key features of each set of provincial/territorial policies, and compares the strength of each case’s policy commitment to harm reduction services. This document begins with an overview of Yukon’s harm reduction policy context including: governance, healthcare delivery structures, substance use trends and harm reduction programming. Next, a description of study methodology is provided, including information about the policy documents retrieved during a systematic search. Finally, we detail the results of our inductive and deductive policy analysis. As no relevant policy documents were found for Yukon, the absence of any formal policy directives is the key finding of this report. 1.1 Contextual Background1 Yukon is one of three northern territories in Canada, spanning 474,712 square kilometers. It has a population of around 33,897, with Whitehorse being its only major city (area of 8,488 km; population of 26,028) (Statistics Canada, 2012). Yukon is the only territory in Canada that operates under a responsible government model rather than a consensus model. Between 2011 and 2016, Darrell Pasloski was premier of Yukon. In 2008, Premier Pasloski publicly stated he had no stance on various harm reduction interventions, such as safe-injection sites or needle-exchange programs, due to not having “enough information”. He would not say whether he personally supported harm reduction strategies or not, only that he supported the platform of the (conservative) party in this regard (Mostyn, 2008). More recently, Sandy Silver was elected Premier in November 2016, representing the Yukon Liberal Party. He has not publicly expressed an opinion on harm reduction or relevant interventions (Yukon Government, 2017). None of the current or previous Ministers of Health and Social Services have publicly spoken about harm reduction in the region, or endorsed any particular stance. 1 Contextual information in sections 1.1 to 1.4 is current up to the end of 2016. 4 1.2 Healthcare Governance The Department of Health and Social Services (DHSS) is responsible for all aspects of healthcare delivery as well as policy development and implementation (Institute of Public Administration of Canada, 2013). While the DHSS provides the overall strategic vision of healthcare in Yukon (Yukon Health and Social Services, 2015A), the corporate services division is primarily responsible for the development of health policies and programs for the territory (Yukon Health and Social Services, 2015B). The remaining three divisions are the main shepherds of health care in the Yukon. The Health Services division is responsible for a plethora of healthcare initiatives such as disease prevention and treatment services and programs (Yukon Health and Social Services, 2015C). The continuing care branch is focused on developing and delivering a full spectrum of health services for the senior and physically disabled population of Yukon (Yukon Health and Social Services, 2016A). Lastly, the social services wing of the department manages and administers programs focused on addressing issues that Yukoners may face such as addiction and mental health, as well as economic and social issues (Yukon Health and Social Services, 2015D). Since 2013, the Yukon Hospital Corporation (YHC) has operated Yukon’s three hospitals. The YHC also operates various programs oriented for indigenous populations in the territory. Eleven of the 14 indigenous communities are self-governing. These 11 groups govern their own lands and are responsible for healthcare delivery and health policy development and implementation. For much of Yukon’s history, healthcare delivery and policy were the responsibility of the federal government. The transfer of power from the federal government to Yukon began in 1993 by transferring the responsibility of the Whitehorse General Hospital to the Yukon Hospital Corporation. The full transfer of power was complete in 1997 whereby the DHSS became responsible for Yukon’s healthcare delivery in the territory (Institute of Public Administration of Canada, 2013). 1.3 Substance Use Trends Substance use data is very limited in Yukon. According to the 2015 Yukon Health Status Report, information and data regarding illicit drug abuse in Yukon is limited as the population “is not routinely surveyed on drug use” (Yukon Health and Social Services, 2015E, pg. 47). Latest information regarding illicit drug