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2022 to 2023 Canada-Nova Scotia Home and Community Care and Mental Health and Addictions Services Funding Agreement

Table of Contents

Funding Agreement

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 NOVA SCOTIA (hereinafter referred to as "Nova Scotia" or "Government of Nova Scotia") as represented by the Minister of Health and Wellness (herein referred to as "the provincial Minister")

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

PREAMBLE

WHEREAS, on December 23, 2016 Canada and Nova Scotia 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 Nova Scotia 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 Nova Scotia 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, Section 6 of Chapter 376 of the Revised Statutes of Nova Scotia, 1989, the Public Service 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 Nova Scotia for the provision of health services which includes home and community care, and mental health and addictions initiatives;

WHEREAS, Nova Scotia 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 Nova Scotia agree as follows:

1.0 Objectives

1.1 Building on Nova Scotia’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 Nova Scotia 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-Nova Scotia 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 Nova Scotia'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 Nova Scotia

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

Mental Health and Addictions Services

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, Nova Scotia’s estimated share of the amounts will be:

Fiscal Year Home and community care
Estimated amount to be paid to Nova Scotia Table 1 footnote * 		Mental health and addictions services
Estimated amount to be paid to Nova ScotiaTable 1 footnote *
2022-2023 $15,560,000 $15,560,000

4.3 Payment

4.3.1 Canada's contribution will be paid in semi-annual installments as follows:

  1. The first installment will be paid within approximately 30 business days of execution of this Agreement by the Parties. The second installment will be paid after November 15.
  2. The first installment will be equal to 50% of the notional amount set out in section 4.2.4 as adjusted by section 4.2.3.
  3. The second installment will be equal to the balance of Canada's contribution for the Fiscal Year as determined under sections 4.2.4 and 4.2.3.
  4. Prior to the second payment, Canada will notify of the amount of the second installment as determined under sections 4.2.4 and 4.2.3.
  5. Canada shall withhold the second payment if Nova Scotia 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
  6. The sum of both installments constitutes a final payment and is not subject to any further adjustment once the second installment has been paid.
  7. 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 Nova Scotia, Nova Scotia 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 Nova Scotia 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, Nova Scotia 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, Nova Scotia 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. Nova Scotia 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, Nova Scotia 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 Chief 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 Nova Scotia will ensure that expenditure information presented in the annual financial statement is, in accordance with Nova Scotia's standard accounting practices, complete and accurate.

5.3 Evaluation

5.3.1 Responsibility for evaluation of programs rests with Nova Scotia 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 Nova Scotia, 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 Nova Scotia 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 Nova Scotia 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 Nova Scotia reserves the right to conduct public communications, announcements, events, outreach and promotional activities about the Common Statement and this Agreement. Nova Scotia 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 Nova Scotia 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 Nova Scotia, 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 Nova Scotia, 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 Nova Scotia shall be:
Jeannine Lagassé and Paul Lafleche
1894 Barrington Street,
Barrington Tower
PO Box 488
Halifax NS B3J 2R8

Email:  jeannine.lagasse@novascotia.ca; paul.lafleche@novascotia.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 Nova Scotia.

12.4 No member of the House of Commons or of the Senate of Canada or of the Legislature of Nova Scotia 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 20th day of March, 2023.

The Honourable Jean-Yves Duclos, Minister of Health

SIGNED on behalf of Canada by the Minister of Mental Health and Addictions at Ottawa, Ontario this 20th day of March, 2023.

The Honourable Carolyn Bennett, Minister of Mental Health and Addictions

SIGNED on behalf of Nova Scotia by the Minister of Health and Wellness at Halifax, Nova Scotia this 8th day of March, 2023.

The Honourable Michelle Thompson, Minister of Health and Wellness

Annex 1 to the Agreement

Common Statement of Principles on Shared Health Priorities

Annex 2 to the Agreement

Nova Scotia’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-Nova Scotia Home and Community Care and Mental Health and Addictions Services Funding Agreement’sFootnote 1, Nova Scotia is planning to use federal funding as follow:

Expenditure Tables

Home and Community Care

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

Enhancing Continuing Care Services for Clients
Support clients of all ages, particularly those with complex care needs by addressing barriers remaining in the community by improving programs and services to better respond to client needs, enhancing community based end-of-life/palliative care, and improving access to coordinated and inclusive programs and services. Examples of improvements include increasing access to clinicians, accessible housing, and availability of home care workers. Federal funds will also be used to augment provincial funding to bolster the Bed Loan program, the Home First program, the Acquired Brain Injury Action Plan and a community-based home lift loan program.

$2.00

Supporting Caregivers
Provide supports and prevent burnout to caregivers  by increasing awareness and access to new and existing caregiver programs and improving services for caregiver mental, psychological and emotional health (e.g. providing virtual care support options for caregivers of acquired brain injury (ABI) survivors).

$3.35

Support Integrated Care
Increase communication between care providers leads to reduce fragmented care and inappropriate use of emergency services, particularly for the First Nations population living on reserve.  Funding will facilitate system integration and coordination of care through expanding the existing Extended Care Paramedic Program and supporting enhanced coordination between the Provincial Continuing Care Program, First Nations and Inuit Home and Community Care Program. Federal funding will also be used to implement an intensive outreach team across Nova Scotia to ensure coordinated responses for children and youth with complex care needs, and to implement a provincial network.

$6.83

Enhancing Sustainability, Accountability and System Performance
Implement a data submission portal for home care service providers that will replace current manual data collection efforts and implement the interRAI Long-Term Care Facilities Assessment Tool in LTC homes to improve the accountability and performance monitoring for the continuing care system.

 $5.64

Total Federal Funding - Home and Community CareTable 2 footnote *

 $17.82

Mental Health and Addictions Services

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

Enhance Integrated Service Delivery for Children and Youth
To improve integrated delivery of mental health services for children and youth, this initiative will expand the existing SchoolsPlus program, through hiring additional mental health clinicians to support the delivery of services across the province, and the CaperBase model to expand the model to other health regions. Funding will also be used to support the Youth Health Centre pilot model to provide better support for at risk youth with emerging health concerns especially in small and rural communities. Supports include navigating primary care supports, providing health promotion activities, and promoting youth involvement and engagement to enhance self-advocacy skills.

$6.8

Enhance Access to Community Based MHA Supports
To increase accessibility to community based mental health supports, especially in rural and First Nations communities, this initiative aims to:

  • Increase the number of mental health clinicians in the community for children and adults (particularly within First Nations communities);
  • Develop and implement a standardize care model that will integrate community-based MHA supports into Nova Scotia’s collaborative primary health care model;
  • Improve access to MHA crisis services; and
  • Invest in technology-based interventions to improve accessibility to MHA services.
 $10.43

Total Federal Funding - Mental Health and Addictions ServicesTable 3 footnote *

$17.23

Footnotes

Footnote 1

https://www.canada.ca/en/health-canada/corporate/transparency/health-agreements/shared-health-priorities/nova-scotia.html#_Nova_Scotia_Action

Return to footnote 1 referrer

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