Today the CRA released its long awaited Guidance on Promotion of Health and Charitable Registration.  This guidance could potentially impact a number of different types of charitable organizations that deal with health care.

Here is a summary:


Reference number

Effective date
August 27, 2013

This guidance replaces the following summary policies: CSP?A19, Alcohol, Drug, Addiction, CSP-A11, Abortion (Medical Clinic) – Women, CSP-C24, Counselling, CSP?C20, Crisis Centre, CSP-D11, Relieving Sickness, Disability, CSP?H02, Provision of Health Care, CSP?H03, Health Clinic, and CSP?M04, Holistic Medicine.


According to the common law, the promotion of health can be charitable. The promotion of health means directly preventing or relieving a mental or physical health condition. To be charitable, a purpose that promotes health must, as a general rule, directly prevent or relieve a physical or mental health condition by providing effective health care services or products to the public in a manner that meets applicable quality and safety requirements.

This guidance groups purposes that promote health into four types:
•core health care (diagnosing and treating health conditions, assisting with rehabilitation, protecting and maintaining public health);
•supportive health care (providing support to individuals diagnosed with health conditions or their caregivers and families);
•protective health care (saving people when lives are in danger by providing health-related emergency services); and
•health care products.`

However, not everything that is done with the intention of promoting health is charitable under the law. To be charitable, every promotion of health purpose must meet the public benefit test by delivering a charitable benefit to the public.

Typically, in the absence of evidence to the contrary, providing the public with health care services or products that are funded under the Canada Health Act or covered under any provincial or territorial medical insurance plan in Canada will be considered to be charitable when applicable quality and safety requirements are met. Otherwise, to further a promotion of health purpose, an organization must generally show that each health care service or product it provides effectively prevents or relieves a physical or mental health condition and meets applicable quality and safety requirements. The guidance explains the criteria for assessing services and products for effectiveness, and quality and safety.

Examples of promotion of health purposes include:
•promoting health by:
?providing the public with in?patient or out?patient medical services;
?providing accident victims with physical, occupational or speech therapy;
?protecting and maintaining public health by slowing the development and progression of heart disease by operating a “healthy heart” program;
?providing individuals with [specify condition] with access to health counselling, information or group support programs;
?providing publicly available ambulance, paramedic or fire-fighting services; or
?providing affected populations with health care products that prevent and manage serious threats to survival and health.“

Here is the link to the Guidance on Promotion of Health and Charitable Registration:

CRA has an interesting explanation of how they arrived at the guidance and how they intend to review this guidance:

“This guidance explains how the Canada Revenue Agency (CRA) interprets and applies the law as it relates to the promotion of health and charitable registration. It was developed in consultation with stakeholders in the charitable sector.

While the CRA is always interested in feedback on its guidance products, a post implementation review is conducted approximately one year after publication and amendments are made as warranted. If you have comments or suggestions, you can go to Ongoing feedback on existing policies and guidance for contact information.“