Alberta Budget 2025: Hospital Foundation Stakeholder Brief

Executive Summary

Budget 2025 delivers $24B in total health spending and $3.6B in health-related capital investment over three years, creating significant partnership opportunities for hospital foundations. The establishment of four integrated provincial health agencies -- Acute Care Alberta, Primary Care Alberta, Assisted Living Alberta, and Recovery Alberta -- fundamentally changes the organizational landscape in which foundations operate. Major capital projects including the Red Deer Regional Hospital Redevelopment ($557M), Diagnostic Imaging Enhancement ($168M), and Medical Equipment Replacement ($90M) offer alignment with traditional foundation fundraising campaigns. However, foundations must navigate organizational uncertainty as the health system refocus reshapes governance, accountability, and partnership structures.

Top 5 Relevant Budget Measures

1. Health capital plan at $3.6B over three years -- spanning hospital construction, diagnostic imaging, medical equipment, EMS, and primary care planning. This includes $1,456M through the Health ministry and additional health facility investment through Infrastructure at $3,444M encompassing both health and other facilities.

2. Four integrated health agencies -- Acute Care Alberta oversees hospitals, urgent care, surgical facilities, and EMS. Primary Care Alberta manages primary care provider teams. Assisted Living Alberta manages continuing care under Seniors, Community and Social Services. Recovery Alberta manages addiction services under Mental Health and Addiction. This restructuring changes the organizational relationships for all hospital foundations.

Red Deer Regional Hospital Centre Redevelopment at $557M -- $129M in 2025-26, $182M in 2026-27, $246M in 2027-28. This is the largest single health facility project in the budget and represents a major foundation campaign opportunity.

Diagnostic Imaging Enhancement at $168M -- $56M per year over three years. Medical imaging equipment is a traditional focus of foundation fundraising, and this program provides a sustained platform for donor support.

Alberta Infrastructure right of first refusal on health entity property -- new legislation will permit property owned by health entities to be transferred to Alberta Infrastructure, with hospitals leased back to entities to operate and maintain. This changes the ownership framework for health facilities and may affect how foundation-funded assets are treated.

Risks

Organizational uncertainty. The creation of four new agencies means that foundations must establish relationships with new leadership, understand new governance structures, and potentially renegotiate partnership agreements. The transition period creates uncertainty about decision-making authority and project approval processes.

Asset ownership changes. The right of first refusal legislation enabling transfer of health entity property to Alberta Infrastructure raises questions about how foundation-contributed assets are tracked, maintained, and governed. Foundations that funded specific equipment or facility improvements need clarity on how these contributions are recognized under new ownership structures.

SUCH sector self-financed capital. Health entity self-financed capital at $770M over three years includes foundation contributions. If foundation fundraising is affected by economic uncertainty, donor fatigue, or organizational disruption, the self-financed capital amount could be at risk.

Donor confidence. Health system restructuring, combined with the $5.2B provincial deficit, may concern donors who question whether their contributions will be effectively used in a changing organizational environment. Maintaining donor confidence requires clear communication about how foundation funds are deployed.

Physician compensation dynamics. The physician compensation budget at $6,990M and the new primary care physician compensation model may affect physician retention in specific facilities. Foundations that support physician recruitment programs need to understand how the new compensation framework changes incentives.

Opportunities

Health capital co-investment. The $3.6B health capital plan provides numerous projects where foundation support can accelerate delivery, enhance scope, or fund complementary equipment. Projects like diagnostic imaging, medical equipment replacement, and specialty centre expansions align with traditional foundation campaign themes.

Red Deer Hospital campaign. The $557M Red Deer Hospital Redevelopment is a flagship project that will serve a large regional population. The Central Alberta Cancer Centre, included within this redevelopment, offers a compelling donor narrative about access to cancer care closer to home.

Diagnostic imaging and equipment. The $168M Diagnostic Imaging Enhancement and $90M Medical Equipment Replacement programs are sustained, multi-year investments in the types of equipment that donors find tangible and meaningful. Foundations can align campaigns with specific equipment purchases at specific facilities.

Primary Care Alberta. The establishment of Primary Care Alberta with a $322M budget creates new partnership opportunities. Foundations in communities underserved by primary care can position themselves as funding partners for primary care innovation, after-hours clinics, and digital health services.

Mental health facilities. Recovery Communities at $147M (combined across Mental Health and Addiction and Infrastructure) and Specialized Mental Health and Addiction Facilities at $210M create opportunities for foundations focused on mental health and addiction services.

Likely Government Intent

The government is restructuring health governance to improve accountability, reduce duplication, and create clearer lines of authority. The four-agency model is designed to create integrated provincial systems for each major health service domain. For foundations, this means the government expects a more coordinated approach to capital planning, with Infrastructure controlling physical assets and the agencies managing service delivery. The government values foundation contributions as supplementary investment that enhances public capital, but the new structure centralizes control over how and where capital is deployed.

Immediate Questions to Ask Ministries

1. Health: How will foundation partnership agreements be structured under the new four-agency model, and who is the decision-making authority for accepting and deploying foundation contributions?

2. Infrastructure: What is the policy for recognizing and protecting foundation-funded assets when health entity property is transferred to Alberta Infrastructure?

3. Health: What is the timeline for Acute Care Alberta and Primary Care Alberta to establish their capital planning processes, and how will foundations be engaged?

4. Infrastructure: What procurement timeline applies to the Red Deer Hospital Redevelopment and other major health facility projects where foundation campaigns are planned?

5. Mental Health and Addiction: How can foundations support Recovery Communities and specialized mental health facility construction?

48-Hour Action Checklist

• Map current foundation campaign priorities against the health capital plan project list
• Contact Health ministry to request briefing on health system refocus and foundation implications
• Review existing partnership agreements for clauses affected by organizational restructuring
• Brief foundation board on budget health spending and four-agency structure
• Assess SUCH sector self-financed capital projections against planned foundation contributions
• Identify diagnostic imaging and medical equipment projects aligned with campaign capacity
• Prepare donor communication on health budget context and foundation partnership value

30-Day Monitoring Checklist

• Track health agency establishment timelines and governance structure announcements
• Engage Acute Care Alberta leadership on partnership frameworks for foundations
• Monitor health capital project procurement schedules for campaign timing alignment
• Review donor confidence indicators and giving patterns in context of health system changes
• Assess Red Deer Hospital Redevelopment milestones and campaign coordination
• Track Infrastructure ministry policies on health entity asset transfers
• Engage with other Alberta hospital foundations on common advocacy positions

Suggested Message Frames

Frame 1 -- Community Health Investment: Hospital foundations are the bridge between community generosity and health care improvements. In a year of $24B health spending and $3.6B capital investment, foundation contributions deliver the margin of excellence -- the advanced equipment, enhanced facilities, and innovative programs that elevate care.

Frame 2 -- Proven Partnership: Foundations have decades of experience funding health care improvements that government budgets alone cannot deliver. As the health system refocuses through four new agencies, foundations are ready to partner with new leadership to continue supporting patient care.

Frame 3 -- Donor Impact Visibility: Budget 2025 health capital projects create tangible opportunities for donors to see their impact -- from diagnostic imaging equipment that detects cancer earlier to medical devices that improve surgical outcomes. Foundation fundraising translates community support into measurable health improvements.

Opposition Narratives to Anticipate

"Foundations should not fund what government should pay for." Counter that foundations enhance publicly funded care, not replace it. The $24B health budget provides baseline funding; foundation contributions add the margin of excellence that advances care quality.

"Health restructuring makes foundation contributions risky." Address this directly by communicating the stability of the foundation's role and the legal protections for donor-designated funds. Foundations have navigated health system changes before and maintain clear accountability for donor contributions.

"Foundation priorities may not align with government priorities." Emphasize that foundations work collaboratively with health system leaders to identify the most impactful investments. The new agency structure may actually create clearer alignment between foundation campaigns and system-wide priorities.

Data Points to Monitor

• Health agency establishment timelines and leadership appointments
• Health capital project procurement schedules and construction milestones
• Diagnostic imaging and medical equipment replacement program details
• Red Deer Hospital Redevelopment procurement and construction progress
• SUCH sector self-financed capital spending against projections
• Infrastructure ministry policies on health entity property transfers
• Donor giving trends and campaign fundraising results
• Foundation operating cost trends and overhead ratios
• Physician recruitment and retention data for foundation-supported programs
• Mental health and addiction facility construction timelines