Implementation agreement on the March 10, 2017 Asymmetrical Agreement: Home and Community Care and Mental Health and Addictions Services for fiscal year 2022-2023

Agreement

BETWEEN:

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

PREAMBLE

WHEREAS Canada and Quebec recognize the importance of increasing early intervention with regard to mental disorders and addictions and share the common objective of improving access to home and community care services within the context of the aging population;

WHEREAS, on September 16, 2004, the Prime Minister of Canada and the Premier of Quebec signed a health agreement entitled Asymmetrical Federalism that Respects Quebec's Jurisdiction, which notably allows for the existence of agreements and arrangements adapted to Quebec's specificity;

WHEREAS, in recognition of Quebec's jurisdiction with regard to health and social services and Quebec's exercise of full control over the planning, organizing and managing of services within its territory, enabling it to implement its own health plans and priorities, Canada and Quebec agreed, on March 10, 2017, to an asymmetrical agreement based on the principles of the asymmetrical agreement of September 2004, including targeted federal funding over 10 years, beginning in 2017-2018, for investments in home and community care and mental health and addictions services, in addition to the existing legislated commitments through the Canada Health Transfer;

WHEREAS the asymmetrical Agreement of March 10, 2017, recognizes that the Government of Quebec itself will continue to report to the Quebec population on the use of all the funding for health and will continue to collaborate with the other governments with regard to the sharing of information and best practices;

WHEREAS Canada authorizes the federal Ministers to enter into agreements with the provinces and territories for the purpose of facilitating the formulation, coordination and implementation of any program or policy within the mandate of the federal Ministers;

WHEREAS, on September 17, 2018, Canada and Quebec entered into the Agreement to Implement the March 10, 2017 Asymmetrical Agreement — Home and Community Care and Mental Health and Addiction Services Component, for the period of April 1, 2018, through March 31, 2022;

WHEREAS this agreement expired on March 31, 2022;

WHEREAS Canada and Quebec wish to enter into a new agreement, which includes substantially the same terms as the previous agreement;

NOW THEREFORE, Canada and Quebec agree as follows:

1.0 Definition

The following expressions used in this Agreement will have the scope defined below:

"Agreement" means this Implementation Agreement on the March 10, 2017 Asymmetrical Agreement – Home and Community Care and Mental Health and Addictions Services for fiscal year 2022-2023.

"Fiscal Year" means the period commencing on April 1 of any calendar year and ending on March 31 of the immediately following calendar year.

2.0 Objectives

2.1 The Parties agree that the goal of this Agreement is to establish the terms and conditions for the payment of Canada's contributions to the funding for home and community care and mental health and addictions services for Fiscal Year 2022-2023.

2.2 To this end, the two Parties agree that Quebec will identify its priorities and will be responsible for designing, implementing, assessing and adapting its policies and programs with regard to home and community care and mental health and addictions services.

3.0 Areas of Investment: Home and Community Care and Mental Health and Addictions Services

3.1 Quebec is responsible for establishing the vision, priorities and objectives for home and community care and mental health and addictions services.

3.2 The funds transferred under this Agreement will be used to support Quebec's objectives and priorities with regard to home and community care and mental health and addictions services, including those identified by Quebec as examples in Appendix 1 to the Implementation Agreement on the March 10, 2017, Asymmetrical Agreement – Home and Community Care and Mental Health and Addictions Services, which was signed on September 18, 2018.

4.0 Term of the Agreement

4.1 The term of this Agreement is one year, from April 1, 2022, to March 31, 2023.

5.0 Financial Provisions

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

5.2 Allocation to Quebec

5.2.1 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 5.2.2 for the term of this Agreement.

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

• F is the total funding available under this initiative as outlined in 5.2.1 in Fiscal Year 2022-2023;
• K is the total population of the province or territory, as determined using the annual population estimates on July 1^st 2022 from Statistics Canada; and
• L is the total population of Canada, as determined using the annual population estimates on July 1, 2022, from Statistics Canada.

5.2.3 Subject to annual adjustment based on the formula in section 5.2.2, Quebec's estimated share of the amounts will be:

5.3 Payment

5.3.1 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 on or about November 15.
2. The first installment will be equal to 50% of the notional amount set out in section 5.2.3 as adjusted by section 5.2.2.
3. The second installment will be equal to the balance of Canada's contribution for the Fiscal Year as determined under sections 5.2.2 and 5.2.3.
4. Prior to the second payment, Canada will notify of the amount of the second installment as determined under sections 5.2.2 and 5.2.3.
5. The sum of both installments constitutes a final payment and is not subject to any further adjustment once the second installment has been paid.
6. Payment of Canada's funding for this Agreement is subject to an annual appropriation by the Parliament of Canada for this purpose.

5.4 Repayment of overpayment

In the event that payments exceed the amount to which Quebec is entitled under this Agreement, the amount of the excess is a debt due to Canada and shall be repaid to Canada upon receipt of a notice to this effect and by the deadline specified in the notice.

6.0 Distribution and Information Sharing

6.1 For a number of years, Quebec has been sharing its health information, expertise and best practices with other governments in Canada and intends to continue this practice.

6.2 Quebec agrees to ensure transparency with regard to the objectives of this Agreement and will continue to do its own reporting to the Quebec population on the use of all funding for healthcare in accordance with its own reporting practices and indicators and will recognize the federal funding obtained under this Agreement.

6.3 Quebec is responsible for the evaluation of its programs in accordance with its own evaluation policies and practices.

6.4 Quebec will use comparable indicators for the purposes of comparing health and social services with other provinces and territories.

6.5 Quebec will participate, as an observer, in the work of the Canadian Institute for Health Information to develop a set of common indicators for home and community care and mental health and addictions services.

6.6 Quebec will ensure that the information on expenditures indicated in the yearly financial statements is complete and accurate and complies with Quebec accounting practices.

7.0 Communications

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

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

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

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

7.5 Canada, with prior notice to Quebec, may, if properly cited, incorporate parts of reports containing data and information or any parts of evaluation and audit reports made public by Quebec into any public report that Canada may prepare for its own purposes, including any reports to the Parliament of Canada or reports that may be made public.

8.0 Dispute Resolution

8.1 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.

8.2 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. Upon such notice, the Parties will endeavour to resolve the issue in dispute bilaterally through their designated officials.

8.3 If a dispute cannot be resolved by the designated officials, the dispute will be referred to the Deputy Ministers of Canada and Quebec responsible for health, and if it cannot be resolved by them, then the ministers responsible for Health respectively for Canada and for Quebec shall endeavour to resolve the dispute.

9.0 Amendments to the Agreement

9.1 The Parties can agree, by mutual consent and in writing, to any amendment to the Agreement. Such amendment will come into effect on such date as may be decided by the Parties. Any amendments shall be in writing and signed, in the case of Canada, by the federal Minister(s) responsible for Health, and in the case of Quebec, by the Minister of Health and Social Services and the Minister Responsible for Canadian Relations and the Canadian Francophonie.

10.0 Termination

10.1 Either Party may terminate this Agreement at any time if it is demonstrated that the terms and conditions are not respected by giving at least six months written notice of its intention to terminate.

10.2 As of the effective date of termination of this Agreement, under section 10.1, 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 considered as received if delivered or sent by mail, with 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.

11.2 The address for notice or communication to Canada shall be:

Health Canada
Brooke Claxton Building
70 Colombine Driveway
Ottawa, Ontario K1A 0K9

Email: jocelyne.voisin@hc-sc.gc.ca

The address for notice or communication to Quebec shall be:

Ministère de la Santé et des Services sociaux
1075 Sainte-Foy Road
Québec, Quebec G1S 2M1

1005 Sainte-Foy Road, 1st Floor
Québec, Quebec G1S 4N4

Email: daniel.desharnais@msss.gouv.qc.ca

12.0 General

12.1 This Agreement constitutes the entire agreement entered into by the Parties.

12.2 This Agreement shall be governed and interpreted in accordance with the laws of Quebec.

12.3 No member of the House of Commons or of the Senate of Canada or of the National Assembly of Quebec shall be admitted to any share or part of this Agreement, or to any benefit arising therefrom.

12.4 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, this 24th day of August, 2022.

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, this 26th day of August, 2022.

The Honourable Carolyn Bennett, Minister of Mental Health and Addictions and Associate Minister of Health

SIGNED on behalf of Quebec by the Minister of Health and Social Services at Québec, this 22nd day of August, 2022.

Mr. Christian Dubé, Minister of Health and Social Services

SIGNED on behalf of Quebec by the Minister responsible for Health and Social Services at Québec, this 23rd day of August, 2022.

Mr. Lionel Carmant, Minister responsible for Health and Social Services

SIGNED on behalf of Quebec by the Minister responsible for Canadian Relations and the Canadian Francophonie at Québec, this 26th day of August, 2022.

Ms. Sonia Lebel, Minister responsible for Canadian Relations and the Canadian Francophonie