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2022 to 2023 Canada-British Columbia Home and Community Care and Mental Health and Addictions Services Funding Agreement

Table of Contents

  1. Funding Agreement
  2. Annex I - Common Statement of Principles on Shared Health Priorities
  3. Annex II - Expenditure Plan

Funding Agreement

BETWEEN:

HIS MAJESTY THE KING IN RIGHT OF CANADA (hereinafter referred to as "Canada" or "Government of Canada") as represented by the Minister of Health and Minister of Mental Health and Addictions and Associate Minister of Health (herein referred to as "the federal Ministers")

- and -

HIS MAJESTY THE KING IN RIGHT OF THE PROVINCE OF BRITISH COLUMBIA (hereinafter referred to as "British Columbia" or "Government of British Columbia") as represented by the Minister of Health and the Minister of Mental Health and Addictions (herein referred to as "the provincial Ministers")

REFERRED to collectively as the "Parties", and individually as a "Party'

PREAMBLE

WHEREAS, on February 17, 2017 Canada and British Columbia agreed to targeted federal funding over 10 years, beginning in 2017-18, for investments in home and community care and mental health and addictions, in addition to the existing legislated commitments through the Canada Health Transfer;

WHEREAS, Canada and British Columbia agreed to a Common Statement of Principles on Shared Health Priorities (hereinafter referred to as the "Common Statement', attached hereto as Annex 1) on August 21, 2017, which articulated their shared vision to improve access to home and community care as well as mental health and addictions services in Canada;

WHEREAS, Canada authorizes the federal Ministers to enter into agreements with the provinces and territories, for the purpose of identifying activities provinces and territories will undertake in home and community care and mental health and addictions services, based on a menu of common areas of action and in keeping with the performance measurement and reporting commitments, consistent with the Common Statement;

WHEREAS, Canada and British Columbia agree that data collection and public reporting of outcomes is key to reporting results to Canadians on these health system priorities, and that the performance measurement approach taken will recognize and seek to address differences in access to data and health information infrastructure;

WHEREAS, the Ministry of Health Act authorizes the provincial Minister to enter into agreements with the Government of Canada under which Canada undertakes to provide funding toward costs incurred by the Government of British Columbia for the provision of health services which includes home and community care, and mental health and addictions initiatives;

WHEREAS, British Columbia makes ongoing investments in home and community care and mental health and addictions services, consistent with its broader responsibilities for delivering health care services to its residents;

AND WHEREAS, the Government of Canada makes ongoing investments in home and community care and mental health and addictions services for Indigenous communities and other federal populations;

NOW THEREFORE, Canada and British Columbia agree as follows:

1.0 Objectives

1.1 Building on British Columbia's existing investments and initiatives, the Parties commit to work together to improve access to home and community care and strengthen access to mental health and addictions services (listed in the Common Statement, attached as Annex 1).

2.0 Action Plan and Expenditure Plan

2.1 British Columbia will invest federal funding provided through this Agreement in alignment with the selected action(s) from each menu of actions listed under home and community care and mental health and addictions services in the Common Statement and the Action Plan (Annex 2 of the Canada-British Columbia Home and Community Care and Mental Health and Addictions Services Funding Agreement (herein the "Previous Agreement').

2.2 Consistent with the initiatives in the Action Plan, Annex 2 sets out the expenditure plan for funding provided through this Agreement. Annex 2 may include a description of any new initiatives. 

3.0 Term of Agreement

3.1 The term of this Agreement is one year, from April 1, 2022 to March 31, 2023 ("the Term').

3.2 Renewal of Agreement

3.2.1 British Columbia's share of the federal funding for 2023-24 to 2026-27, based on the federal commitment in Budget 2017 of $11 billion over ten years, could be provided upon the renewal of an agreement, subject to appropriation by Parliament, and the Parties' agreement on a new Action Plan. A future agreement would provide the Parties an opportunity to review and course correct, if required, and realign new priorities based on progress made to date.

4.0 Financial Provisions

4.1 The contributions made under this Agreement are in addition and not in lieu of those that Canada currently provides under the Canada Health Transfer to support delivering health care services within the jurisdictions.

4.2 Allocation to British Columbia

4.2.1 In this Agreement, "Fiscal Year' means the period commencing on April 1 of any calendar year and terminating on March 31 of the immediately following calendar year.

4.2.2 Canada has designated the following maximum amounts to be transferred in total to all provinces and territories under this initiative based on the allocation method outlined in subsection 4.2.3 for the Term of this Agreement.

Home and Community Care

  1. $600 million for the Fiscal Year beginning on April 1, 2022

Mental Health and Addictions Services

  1. $600 million for the Fiscal Year beginning on April 1, 2022

4.2.3 Funding will be allocated to provinces and territories on a per capita basis. The per capita funding is calculated using the following formula: F x K/L, where:

4.2.4 Subject to annual adjustment based on the formula described in section 4.2.3, British Columbia's estimated share of the amounts will be:

Fiscal Year Home and community care
Estimated amount to be paid to British Columbia Table 1 footnote *		 Mental health and addictions services
Estimated amount to be paid to British Columbia Table 1 footnote *
2022-2023 $81,983,109 $81,983,109

4.3 Payment

4.3.1 Canada's contribution will be paid in full as follows:

  1. The full amount as set out in section 4.2.3 funding formula will be paid within approximately 30 business days of execution of this Agreement by the Parties. Canada shall withhold the payment if British Columbia has failed to provide its annual financial statement for the previous Fiscal Year pursuant to the Previous Agreement or to provide data and information related to home and community care and mental health and addictions to the Canadian Institute for Health Information (CIHI) for the previous Fiscal Year in accordance with section 5.1.
  2. This constitutes a final payment and is not subject to any further adjustment once the installment has been paid.
  3. Payment of Canada's funding for this Agreement is subject to an annual appropriation by the Parliament of Canada for this purpose.

4.4 Carry Over

4.4.1 In the event this Agreement is renewed in accordance with the terms of section 3.2.1, and at the request of British Columbia, British Columbia may retain and carry forward up to 10 percent of funding provided in this Agreement that is in excess of the amount of the eligible costs actually incurred and use the amount carried forward for expenditures on eligible areas of investment incurred in Fiscal Year 2023-24. Any request to retain and carry forward an amount exceeding 10 percent will be subject to discussion and mutual agreement in writing by the Designated Officials via an exchange of letters.

4.5 Repayment of overpayment

4.5.1 In the event payments made exceed the amount to which British Columbia is entitled under this Agreement, the amount of the excess is a debt due to Canada and, unless otherwise agreed to in writing by the Parties, British Columbia shall repay the amount within sixty (60) calendar days of written notice from Canada.

4.6 Use of Funds

4.6.1 The Parties agree that funds provided under this Agreement will only be used in accordance with the areas of action outlined in Annex 2.

4.7 Eligible Expenditures

4.7.1 Eligible expenditures under this Agreement are the following:

5.0 Performance Measurement and Reporting to Canadians

5.1 Funding conditions and reporting

5.1.1 As a condition of receiving funding, British Columbia agrees to participate in a Federal-Provincial-Territorial process, including working with stakeholders and experts, through CIHI, to continue the development of common indicators and to share relevant data in order to permit CIHI to produce annual public reports that will measure pan-Canadian progress on home and community care and mental health and addictions services.

  1. British Columbia will designate an official or official(s), for the duration of this agreement, to work with CIHI and represent its interests related to performance measurement and reporting for home and community care and mental health and addictions services.

5.1.2 By no later than October 1, 2022 and October 1, 2023, in respect of the previous Fiscal Year, British Columbia agrees to:

  1. Provide to CIHI data and information (based on existing and new indicators) related to home and community care and mental health and addictions services annually. This will support CIHI to measure progress on the shared commitments outlined in the Common Statement and report to the public.
  2. Provide to Canada an annual financial statement, with attestation from the province's Ministry of Health's Executive Financial Officer, of funding received the preceding Fiscal Year from Canada under this Agreement or the Previous Agreement compared against the Action Plan, and noting any variances, between actual expenditures and the Action Plan:
    1. The revenue section of the statement shall show the amount received from Canada under this Agreement during the Fiscal Year;
    2. The total amount of funding used for home and community care and mental health and addictions programs and services;
    3. If applicable, the amount of any amount carried forward under section 4.4; and
    4. If applicable, the amount of overpayment that is to be repaid to Canada under section 4.5.

5.2 Audit

5.2.1 British Columbia will ensure that expenditure information presented in the annual financial statement is, in accordance with British Columbia's standard accounting practices, complete and accurate.

5.3 Evaluation

5.3.1 Responsibility for evaluation of programs rests with British Columbia in accordance with its own evaluation policies and practices.

6.0 Communications

6.1 The Parties agree on the importance of communicating with citizens about the objectives of this Agreement in an open, transparent, effective and proactive manner through appropriate public information activities.

6.2 Each Party will receive the appropriate credit and visibility when investments financed through funds granted under this Agreement are announced to the public.

6.3 In the spirit of transparency and open government, Canada will make this Agreement, including any amendments, publicly available on a Government of Canada website.

6.4 Canada, with prior notice to British Columbia, may incorporate all or any part of the data and information in 5.1.2, or any part of evaluation and audit reports made public by British Columbia into any report that Canada may prepare for its own purposes, including any reports to the Parliament of Canada or reports that may be made public.

6.5 Canada reserves the right to conduct public communications, announcements, events, outreach and promotional activities about the Common Statement and this Agreement. Canada agrees to give British Columbia 10 days advance notice and advance copies of public communications related to the Common Statement, this Agreement, and results of the investments of this Agreement.

6.6 British Columbia reserves the right to conduct public communications, announcements, events, outreach and promotional activities about the Common Statement and this Agreement. British Columbia agrees to give Canada 10 days advance notice and advance copies of public communications related to the Common Statement, this Agreement, and results of the investments of this Agreement.

7.0 Dispute Resolution

7.1 The Parties are committed to working together and avoiding disputes through government-to-government information exchange, advance notice, early consultation, and discussion, clarification, and resolution of issues, as they arise.

7.2 If at any time a Party is of the opinion that the other Party has failed to comply with any of its obligations or undertakings under this Agreement or is in breach of any term or condition of the Agreement, that Party may notify the other Party in writing of the failure or breach. Upon such notice, the Parties will endeavour to resolve the issue in dispute bilaterally through their designated officials, at the Assistant Deputy Minister level ("Designated Officials").

7.3 If a dispute cannot be resolved by Designated Officials, then the dispute will be referred to the Deputy Ministers of Canada and British Columbia responsible for health, and if it cannot be resolved by them, then the federal Minister(s) and the provincial Minister(s) shall endeavour to resolve the dispute.

8.0 Amendments to the Agreement

8.1 The main text of this Agreement may be amended at any time by mutual consent of the Parties. Any amendments shall be in writing and signed, in the case of Canada, by the federal Minister(s), and in the case of British Columbia, by the provincial Minister(s).

8.2 Annex 2 may be amended at any time by mutual consent of the Parties. Any amendments to Annex 2 shall be in writing and signed by each Party's Designated Official.

9.0 Equality of Treatment

9.1 During the term of this Agreement, if another province or territory, except the province of Quebec, enters into a home and community care and mental health and addictions services agreement with Canada, or the Parties agree to an amendment to such an agreement and if, in the reasonable opinion of British Columbia, any provision of that agreement or an amended agreement is more favourable to that province or territory than the terms set forth in this Agreement, Canada agrees to amend this Agreement in order to afford similar treatment, upon request. This includes any provision of the Agreement except for the Financial Provisions set out under section 4.0. This amendment shall be retroactive to the date on which the Agreement or the amendment to such an agreement with the other province or territory came into force.

10.0 Termination

10.1 Either Party may terminate this Agreement at any time if the terms are not respected by giving at least 6 months written notice of intention to terminate.

10.2 As of the effective date of termination of this Agreement, Canada shall have no obligation to make any further payments.

11.0 Notice

11.1 Any notice, information, or document provided for under this Agreement will be effectively given if delivered or sent by letter or email, postage or other charges prepaid. Any communication that is delivered will be deemed to have been received in delivery; and, except in periods of postal disruption, any communication mailed by post will be deemed to have been received eight calendar days after being mailed.

The address for communication to Canada shall be:
Health Canada
70 Colombine Driveway
Brooke Claxton Building
Ottawa, Ontario
K1A 0K9

Email: jocelyne.voisin@hc-sc.gc.ca

The address for communication to British Columbia shall be:
Ministry of Health
Intergovernmental Relations
Office of the Deputy Minister
PO Box 9637 STN PROV GOVT
Victoria, BC
V8W 9P1
Email: Darlene.Therrien@gov.bc.ca

12.0 General

12.1 This Agreement, including Annexes 1 and 2, comprise the entire Agreement entered into by the Parties.

12.2 This Agreement is based on the Common Statement of Principles on Shared Health Priorities, Annex 1, finalized on August 21, 2017.

12.3 This Agreement shall be governed by and interpreted in accordance with the laws of Canada and British Columbia.

12.4 No member of the House of Commons or of the Senate of Canada or of the Legislature of British Columbia shall be admitted to any share or part of this Agreement, or to any benefit arising therefrom.

12.5 If for any reason a provision of this Agreement, that is not a fundamental term, is found by a court of competent jurisdiction to be or to have become invalid or unenforceable, in whole or in part, it will be severed and deleted from this Agreement, but all the other provisions of this Agreement will continue to be valid and enforceable.

SIGNED on behalf of Canada by the Minister of Health at Ottawa, Ontario this 16th day of January, 2023.
The Honourable Jean-Yves Duclos, Minister of Health

SIGNED on behalf of Canada by the Minister of Mental Health and Addictions and Associate Minister of Health at Ottawa, Ontario this 9th day of January, 2023.
The Honourable Carolyn Bennett, Minister of Mental Health and Addictions and Associate Minister of Health

SIGNED on behalf of British Columbia by the Minister of Health at Victoria, British Columbia this 19th day of December, 2022.
The Honourable Adrian Dix, Minister of Health

SIGNED on behalf of British Columbia by the Minister of Mental Health and Addictions at Victoria, British Columbia this 5th day of December, 2022.
The Honourable Sheila Malcolmson, Minister of Mental Health and Addictions

Annex 1 to the Agreement

Common Statement of Principles on Shared Health Priorities

Annex 2 to the Agreement

British Columbia's Expenditure Plan on Home and Community Care and Mental Health and Addictions Services 2022-2023

Building on the Action Plan in Annex 2 of the previous Canada-British Columbia Home and Community Care and Mental Health and Addictions Services Funding Agreement'sFootnote 1, British Columbia is planning to use federal funding as follow:

Home and Community Care

Funding allocation by initiative
Initiative 2022-23 ($M)

Home and Community Care Services
BC is supporting the integration of Specialized Community Services Programs with Primary Care Networks, focused on providing the appropriate level of  care/support at home and in the community and thereby reducing hospital and emergency department visits. Federal funds, combined with provincial funding, will be used for:

  • Home support – Increasing access to in-home assistance and respite (e.g. increasing service hours for recently discharged and at risk clients), while establishing Primary Care Networks linkages and improving continuity.
  • Community-based professional services – Increasing access to professional services (e.g. nursing and allied care) and improving the quality and timeliness of care for adults with complex conditions.
  • Community-based caregiver supports – Providing assistance to informal family/friend care providers to support complex clients in their homes, where possible, by improving access to health authority services.
  • NGOs, including seniors' centres - Strengthening relationships and linkages between health authorities and community-based/NGO services to create a system of care that supports seniors living in the community with complex and chronic health challenges and/or at risk of frailty.
  • Technology and infrastructure - Leveraging technology and infrastructure to increase the provision of home and community care to clients, and improve communication with clients and between interdisciplinary team members.
 $82

Palliative and End-of-Life Care
Accelerate progress in the area of community-based palliative care services and shift the focus away from Emergency Departments/hospital utilization. Examples of how federal funds will be used include support to:

  • Improve palliative and end-of-life care services through more community hospice beds,
  • Increase access to 24/7 community-based palliative and end-of-life care services,
  • Further Investment in the BC Centre for Palliative Care to advance best practices, and
  • Support access to post-hospitalization supports, such as the after-hours palliative nursing services.
 $12
Total Federal Funding - Home and Community Care $94

Mental Health and Addictions Services

Funding allocation by initiative
Initiative ($M)

Strengthen the capacity of primary care to respond to mental health and addictions, with a focus on prevention/early intervention and children/youth
As an integral component of Primary Care Networks, the province is supporting a range of evidence-based interventions (including virtual care) designed to offer primary care professionals referral tools to help prevent and intervene early with common and debilitating mental disorders.  Examples include programs like the Anxiety program, which helps parents support children who are dealing with anxiety and provides early access to culturally appropriate supports and services for Indigenous families; and, Mental Health First Aid, SafeTALK and ASIST, which provide services in school-based settings, recognizing diversity, including Indigenous, LGBTQ2S, immigrant, refugee and newcomer student communities.

 $29

Expand access to culturally safer and trauma informed mental health and addictions services for Indigenous communities
Supporting efforts led by the First Nations Health Authority, funding will be used increase the number of individuals and communities with access to culturally safer, trauma-informed and culturally appropriate healing and treatment services and mental health and substance use care, while building on a longer-term strategy to address the mental health and substance use needs of Indigenous peoples.

 $15

Improve seamlessness across systems of care so that people can ask once and get help fast
Supporting the incremental expansion of access to integrated services centres across the Province, especially youth, and building a virtual workforce designed to provide timely mental health and addictions care through virtual clinic access points.

 $10

Increase access for students to mental health and addictions prevention and early intervention services
Supporting sector-wide training to identify and intervene early, as well as improve mental health and substance use literacy amongst parents, students, school staff, and teachers.

$9

Expand access to evidence-based prevention, early intervention, treatment, and recovery options for vulnerable populations
Supporting targeted interventions for vulnerable populations to identify and mitigate problems at an early stage (e.g., reduce risk and enhance protective factors), as well as evidence-based treatment options for individuals with severe addictions, including hospital and community-based services for at-risk pregnant and postpartum women challenged with substance use.

 $27
Total Federal Funding - Mental Health and Addictions Services $90

Footnotes

Footnote 1

The total federal funding for 2022-23 includes the amount of funding (HCC $12M and MHA $8M) carried forward from fiscal year 2021-22.

Return to footnote 1 referrer

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