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.
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"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.
"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.
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.
"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.
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