Policy Advisories Bill 15 in Québec, and its impact on healthcare philanthropy Sara Krynitzki Dec 5, 2023 5 mins read News & Insights Policy Advisories Bill 15 in Québec, and its impact on healthcare philanthropy Earlier this year, the Québec government introduced major, historic legislation with the goal of addressing the performance of the province’s healthcare system. It aims to form a new centralized agency called Santé Québec to oversee all activities related to the public health-care system. This new agency would become the single employer for all of the province’s healthcare employees. Bill 15’s extensive changes will have widespread impacts across many facets of society in the province, including for philanthropy. It may also set precedents for the rest of Canada. In its original wording, this new agency had the power to reallocate resources – including those supported by philanthropy – between institutions and issues. PFC, along with several PFC members and their health charity partners have been following the issue and the Bill’s potential effect on the independence of philanthropy and civil society, and its implications vis-a-vis donations to health charities in Québec. The Bill has now seen two substantial rounds of amendments, and it is expected to pass in the Québec National Assembly in mid-December. The government intends to give the President and Executive Directors of each institution the sole authority to receive and manage philanthropic gifts. The Minister of Health, Christian Dubé, has insisted that the intent of gifts will be fully respected by Santé Québec and that philanthropy will be unaffected by the proposed reforms. PFC has been in regular communication with elected officials and with leaders working with government regarding the concerns specific to philanthropy. We have also consulted legal experts with extensive experience in charity law in the context of Québec, on the implications for our network. The reforms — the second largest piece of legislation ever in Québec — are increasingly becoming an issue of public debate: with health practitioners, with local communities (notably English speaking ones) and with six former premiers concerned about the centralization thrust behind the legislation. Ramifications of legislation for philanthropy Because of the deep and complex range of the changes that will result from Bill 15 being enacted, it will take time for all of the ramifications to be understood. However, our current analysis as they relate to philanthropy are as follows. On the question of legal entities When Bill 15 passes, the existing hospitals and healthcare institutions will be amalgamated into Santé Québec. The rights and obligations of the amalgamating hospitals and organizations will become rights and obligations of Santé Québec. Santé Québec will have legal personality, and none of the amalgamated hospitals and health centres will have separate legal personalities. This means that Santé Québec will hold all the property, rights and obligations of the original entities throughout the entire province of Québec. The existing hospitals and healthcare institutions will become mere unincorporated administrative units of Santé Québec called “institutions”. On the question of how health institutions can receive gifts Santé Québec meets the definition of a crown corporation, and thus should be able to operate as a qualified donee under the Income Tax Act (Canada) and the Taxation Act (Québec). This would allow Santé Québec to receive gifts from charities raising funds for healthcare needs. On the question of how to ensure gifts go where they are intended The latest amendments to Bill 15 indicate that when Bill 15 becomes law, Santé Québec “must allocate to one of its institutions the gifts, legacies and other contributions it receives and that the contributors intended for that institution.” In other words, the amendment makes clear that gifts must go to an institution if the donor clearly indicates such intention. However, there is a concern that after the contribution is used, resulting assets may be moved as Santé Québec decides. We will continue to seek clarity on this issue. It is important to note that without an indication as to the intention of which institution or issue a contribution is meant to support, the contribution would technically be a contribution to Santé Québec to form part of its general assets. Recommendations to the PFC network interested in contributing to a Québec healthcare institution PFC is recommending that those wishing to make a contribution to support an institution of Santé Québec, ensure that they do so with a corresponding foundation for that institution and be as specific as required as to its use (issue, geographic location, and duration). They should ensure that the foundation has or will have in place a formal agreement with Santé Québec that clearly sets out the use of the funds, including its location and scope for the allocation of the funds, and accounting for the use of funds, before the funds are transferred to Santé Québec. As the bill makes its way through the legislative process, PFC will be monitoring, and we will share further developments with our network as they arise. 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