February

Board Meeting 55th Meeting

Ville Saint-Laurent Boardroom
Tuesday, February 8, 2005 at 2:00 p.m.

Present:

Ms. Cheryl Campbell Steer
Ms. Hélène Darby
Dr. Francine Décary
Mr. Christian Gendron
Dr. Jean-François Hardy
Dr. André Lebrun
Mr. Jean-Guy Lorrain (Hemovigilance Committee Observer)
Dr. Serge Montplaisir
Dr. Lucie Poitras
Dr. Yves St-Pierre

Absent:
Ms. Carole Deschambault
Dr. Marc Dionne

Guests:
Ms. Djénane André, Meeting Assistant
Me. Véronique Girard, Interim Vice-President, Legal Affairs
Mr. Guy Lafrenière, Vice-President, Finance and Administration
Héma-Québec

1. Call to order
Dr. André Lebrun acted as meeting chairperson. He welcomed the members present. Quorum was established, and the meeting was called to order at 2:03 p.m.

2. Adoption of the agenda
Motion to adopt the agenda with the following changes:

  • 8.3 2003–2004 Report Card on Canada’s Blood System by the Canadian Hemophilia Society
  • 8.4 Research and Development section on Héma-Québec’s Web site
  • 9.1 Complexity of the forms issued by the integrated information system on transfusions and hemovigilance (SIIATH—Système d’information intégré sur les activités transfusionnelles et d’hémovigilance)
  • 9.2 Prion filters: recent developments

Seconded. Adopted unanimously.

3. Adoption of the minutes of the 54th meeting held on December 15, 2004
Motion to adopt the minutes of the 54th meeting of the Board held on December 15, 2004, as presented. Seconded. Adopted unanimously.

4. Unfinished business from the minutes of the 54th meeting
4.1. Negotiation of the collective agreement with the Syndicat des infirmières et infirmiers de Héma-Québec (CSN) in Québec City: update

On January 11, 2005, Héma-Québec sent a letter to the nurses at the Québec City facility to explain its position with respect to negotiations. Héma-Québec must now decide if it will send a request to the Commission des relations du travail to force the union local to hold a secret vote on the last collective agreement proposal. The CEO emphasized that the present situation is not having any adverse financial effect on Héma-Québec.

A follow-up will be presented at the next meeting.

4.2. 2004–2005 funding of “other services”
There has been progress although there has still not been any formal agreement between Héma-Québec and the Ministère de la Santé et des services sociaux (MSSS) for the 2004–2005 funding of tissues and the cord blood bank. It would seem that the latter will be funded by Héma-Québec’s budget surpluses for this financial year. The President and CEO informed Board members that the MSSS is probably going to grant Héma-Québec the exclusive rights to supply tissues in Québec as of April 1, 2005. Moreover, a pilot project with the eye bank at the Hôpital Maisonneuve-Rosemont is presently being developed.

4.3. WNV: seasonal analysis
There are fewer than 30 days remaining for Health Canada to respond to Héma-Québec’s second submission for the seasonal analysis of the West Nile virus (WNV), unless clarifications are requested at the last moment, as was the case with other recent requests.

Héma-Québec finally received the documents relating to its first submission for the seasonal analysis of the WNV following its request for access to information. These documents contain little new information. They do show, however, that the decisions were made in response to scientific considerations.

4.4. Héma-Québec’s SIGRHQ (integrated human resources management system)
The Audit Committee held a special telephone conference on February 2, 2005, to analyze the update of the financial portion of the SIGRHQ project. This update was carried out at the request of the Audit Committee which wanted the expenditures inherent to the project to be isolated. The presentation made to the Audit Committee was distributed to Board members at the meeting.

The Chairperson of the Audit Committee emphasized that following the update, the project cost now amounts to $2,407,000 over two years. She explained that the system chosen, SAP, is a very robust but expensive system. It is already being used and appreciated in other sectors at Héma-Québec. The financial analysis revealed a reimbursement period of 8 years, which falls within the useful life of the system of 10 years. She reminded the Board that this system aims to correct the weaknesses identified in the past with regard to the system overseeing salaries, which represent 50% of Héma-Québec’s expenses. It is, therefore, a question of a strategic investment.

The Vice-President, Finance and Administration, joined the meeting.

The Vice-President, Finance and Administration, reviewed the presentation made to the Audit Committee. Capital assets now total $1,387,000 instead of the $1,511,000 announced in September 2004. As for operation expenditures, they now amount to $1,020,000 for a variance of $1,144,000. Earnings over 10 years were appraised at $6,773,000 instead of the $11,948,000 as presented in September 2004.

The Chairperson of the Audit Committee emphasized that the greatest earnings were in the area of productivity gains that were appraised at $400,000 per year over 10 years. These gains in productivity as well as the contingency for consultants will have to be monitored very closely.

After reviewing the project, the Audit Committee recommended that the Board approve the SIGRHQ project at a cost of $2,407,000 over two years.

Discussion. Motion to adopt the resolution to approve Héma-Québec’s SIGRHQ (integrated human resources management system) in the amount of $2,407,000 over two years. Seconded. Adopted unanimously.

4.5. Héma-Québec’s responses to Health Canada’s observations
Héma-Québec’s responses to the observations made by Health Canada following its inspection of the Montréal facility between November 17 and 30, 2004, were distributed prior to the meeting. Members did not have any questions about them.

5. Financial Affairs
5.1. Management report to December 31, 2004

The Vice-President, Finance and Administration, presented the management report to December 31, 2004.

The budget comparisons by major categories, variances and statistics are detailed as well as capital asset acquisitions and cash asset fluctuations.

Héma-Québec’s total budget of $284,417,416, which was approved by the Board in November 2003, was revised downward by the Board to $263,853,000 on November 17, 2004. To date, the Héma-Québec budget remains within the projections made at the Board meeting on November 17, 2004. Consequently, the MSSS will reduce the two last payments in order to align itself with the mid-year forecast.

5.2. Operational adjustments faced with reductions in the volume of operations
The Vice-President, Finance and Administration, presented the actions taken in this regard since the last Board meeting. The file has been called “défi-ÉTAPES” (step-by-step challenges). ÉTAPES is the acronym for Effectiveness, Transformation, Adjustment, Performance, Efficiency and Survey. The Vice-President, Finance and Administration, reminded the Board that the goal of défi-ÉTAPES is to undertake a series of actions to attain the goal of maintaining the budgeted and actual cost for packed red blood cells at less than $400 in the new context of a reduction or stagnation in delivery volumes during 2005–2006.

The Vice-President, Finance and Administration, presented the progress report for the five proposed actions to the Board at its last meeting.

The review of additional positions for 2005–2006 has just about been completed. Of the seven positions, one has been phased out voluntarily, four have been recommended for approval and two are still being analyzed. The CEO added that she issued a memorandum on February 1, 2005, announcing a moratorium on creating and staffing positions.

As for the identification of ways for all Héma-Québec managers to be more economical, they were able to produce a list of 64 departmental courses of action for a total savings of $1,930,000. Twenty-five courses of action for the organization as a whole were received, and their analysis is underway. Some departmental courses of action could also be extended to the organization as a whole.

The project review was completed by the Management Committee. The number of projects has fallen from 59 in 2004–2005 to 32 in 2005–2006. Nine projects have been identified as strategic projects of which the major ones are follow-ups to last year’s projects.

The fourth action concerned accounting by activity—flexible budget and integrated performance indicators. The action plan is presently being developed.

Finally, a committee was established to reorganize Héma-Québec’s procedures. The work of this committee will be spread over several months.

The details of the reduction efforts received per division for 2004–2005 and 2005–2006 were presented. The reduction efforts for 2004–2005 total $3,308,000. For 2005–2006, they total $4,746,000, without taking into account any corporate savings and the review of business procedures.

The Vice-President, Finance and Administration, emphasized that the 2005–2006 budget granted to managers is based on an anticipated delivery volume of 228,000 units of packed red blood cells, which represents an increase of 2% over the actual 2004–2005 deliveries. On the basis of this delivery volume, the reduction to achieve in relation to the budget approved by the Minister is $2,700,000 for the variable costs and $2,800,000 for the fixed costs. At the present time, the effort carried out has resulted in a reduction of $2,750,000 for the variable costs and $2,000,000 for the fixed costs. Héma-Québec is, therefore, within $800,000 of the established target and is confident that this target will be reached after the analysis of the courses of action for corporate savings and the review of business procedures. Héma-Québec’s concern is focussed more on the delivery volume projection. In fact, it seems that the year 2004–2005 will end with a delivery volume of approximately 220,000 units. In this context, it is not certain that Héma-Québec can meet its objective of maintaining the price for a unit of packed red blood cells below $400.

The CEO emphasized that the expiration data obtained from the MSSS for the year 2003–2004 do not allow for any explanation for the decrease in delivery volumes any more than the increased use of erythropoietin. A Board member suggested that the transfusion practice in surgery has perhaps changed over the past years. He suggested hiring a summer student/intern to study transfusion practices in surgery. Hôpital Sainte-Justine and Dr. Jean-François Hardy would be interested in participating in such a study. It would be justified to see if the Héma-Québec Foundation could finance this project.

The Vice-President, Finance and Administration, withdrew from the meeting.

6. Safety of the supply
6.1. Pathogens under surveillance: update
The CEO informed members of the recent changes to the operating report with regard to the pathogens under surveillance. These changes involve hepatitis E, HHV-8 and vCJD (three confirmed cases of bovine spongiform encephalopathy in Canada).

7. Management Report
Héma-Québec’s unique identity applies to all of its activities

The CEO informed members that the name Histo-Québec for the tissues division will be discontinued. A recent survey has shown that this name created confusion among clients and that it would be preferable to use the name Héma-Québec for all of the organization’s activities. Héma-Québec’s new visual identity referring to its activities in the fields of blood products, human tissues and stem cells will be presented to Board members at the next meeting.

8. Tabling of documents
8.1. News release describing the results of Héma-Québec’s holiday campaign
The news release describing the results of Héma-Québec’s holiday campaign was distributed to members prior to the meeting. One member asked if the results of the holiday campaign are comparable to last year’s results. A follow-up on this subject will be made at the next meeting.

8.2. Héma-Québec’s record in occupational health and safety
The report of the activities of Héma-Québec’s occupational health and safety department was distributed prior to the meeting. This report shows that the costs of accidents attributed to Héma-Québec have been falling constantly since 1999, as are the costs per accident. Board members congratulated Héma-Québec for its performance in this area.

8.3. 2003–2004 Report Card on Canada’s Blood System by the Canadian Hemophilia Society (CHS)
The evaluation of Héma-Québec’s performance is excellent in all areas with the exception of the one involving self-sufficiency in products derived from plasma, which, according to the CHS, does not seem to be a priority for Héma-Québec. According to the CHS, although total self-sufficiency for all fractionated plasma products is no longer a desirable or realistic goal, a higher degree of self-sufficiency includes certain undeniable advantages. Héma-Québec asked the CHS for explanations with regard to the undeniable advantages. These would be of a financial nature.

It had already been anticipated that the CEO would resubmit the self-sufficiency in plasma report to the Board this spring.

Board members are also surprised by the marks awarded to the MSSS on this report card. They feel that the Secrétariat du sang should respond to this report.

The CEO withdrew from the meeting.

8.4. Research and Development section on Héma-Québec’s Web site
The Interim Vice-President, Legal Affairs, informed Board members that the section of the Héma-Québec Web site relating to research and development is online, which responds to one of the recommendations made on several occasions by the Scientific and Medical Advisory Committee.

9. Other business
9.1. Complexity of the forms issued by SIIATH
A Board member pointed out that that forms developed by SIIATH to ensure traceability are extremely onerous to manage, particularly in the case of patients who have had multiple transfusions. He wondered who should be approached about this problem. It was suggested he should communicate with Dr. Ann Fortin at the Secrétariat du sang and with Dr. Pierre Ouellet, Chairperson of the Committee of Blood Bank Directors.

9.2. Prion filters: recent developments
A Board member would like to find out about the recent developments relating to prion filters so that the Board will be in a position to make adequate decisions when they become available on the market. A follow-up to this subject will be made at the next meeting.

10. Next meeting
The next meeting will be held on March 2, 2005, at the Montréal facility.

11. Adjournment
Unanimous decision to adjourn the meeting at 4:35 p.m.