Safe Long-term Care Fund: Letter of Agreement to Amend Canada-Newfound land and Labrador Funding Agreement

The Honourable Patty Hajdu
Minister of Health
House of Commons
Ottawa, ON K1A 0A6

July 22, 2021

Dear Minister Hajdu,

As you know, the COVID-19 pandemic has created significant challenges for Canadians, and has disproportionately affected those residing in long-term care facilities, assisted living facilities, and seniors' residences. Outbreaks in these facilities have taken the lives of some of Canada's most vulnerable citizens, and forever changed the lives of families and caregivers. To address this crisis, since spring 2020 Newfoundland and Labrador has been working to improve the safety of care for those living in long-term care settings, and those who care for them, through a broad range of measures for enhanced infection prevention and control and supported by federal investments and resources, including most recently the $740M from the September 2020 Safe Restart Agreement funding.

Further to the Government of Canada's commitment on November 30, 2020 to further support provinces and territories through a new Safe Long-term Care Fund, providing jurisdictions an additional $1 billion, Canada and Newfoundland and Labrador agree, through this Letter of Agreement, to amend the Canada-Newfoundland and Labrador Home and Community Care and Mental Health and Addiction Services Agreement (the Bilateral Agreement), in accordance with appendices A and B to this Letter, with the aim of further protecting Canadians who reside in these settings through increased infection prevention and control measures.

The amendments establish the terms and conditions that apply to the Safe Long-term Care funding and include the following:

• The Government of Canada will provide Newfoundland and Labrador with total funding of up to $15.4M, in fiscal year 2021-22 under the Safe Long-term Care Fund for eligible expenditures incurred from December 1, 2020 to March 31, 2022.
• The federal funding through the Safe Long-term Care Fund will support Newfoundland and Labrador to increase infection prevention and control in long-term care facilities, and seniors' residences providing continuing care services. Priorities for initiatives supported by this funding will include retention measures for existing staff, including wage top-ups, and/or hiring of additional human resources; new infrastructure and renovations to existing infrastructure, such as ventilation, or self-isolation or single rooms; and, readiness assessments to prevent COVID-19 infections and spread.
• The funding will also support other infection protection and control efforts, including:
  • Ensuring that residential care homes have dedicated Infection Control Practitioners (ICPs). ICPs will provide education, training on best practice in infection prevention and control (IPAC), identify opportunities to improve IPAC, lead outbreak management activities, monitor homes for compliance to operational standards related to IPAC.
  • Providing infrastructure upgrades to long-term care homes including ventilation upgrades, furniture replacement to meet IPAC standards, development of accessible, sheltered outdoor recreation spaces to support increased quality of life for residents and space for family visitation and equipment upgrades including commodes and privacy drapes to support isolation of residents.
  • Offering an Infrastructure and Equipment Grant Program for private, for-profit providers. Eligible providers can access 75 per cent of the cost of the pre-approved project, up to a maximum of $25,000 per home.
• Newfoundland and Labrador has attached an action plan (Appendix B) which includes: the background on long-term care in Newfoundland and Labrador; efforts undertaken since spring 2020 to mitigate the impact of COVID-19 in long-term care settings, and particularly efforts to enhance infection prevention and control, including activities supported by the Safe Restart Agreement funding; details on the new or enhanced initiatives that will be supported by the Safe Long-term Care Fund in the three priority and other eligible areas, along with a breakdown of planned expenditures and the individual facilities benefiting from this funding; and performance measures to track progress (measures, targets and outcomes).
• Newfoundland and Labrador will put in place cost-recovery agreements with any private for-profit facilities that benefit from the funding under the Safe Long-term Care Fund by December 1, 2021 to ensure that federal investments are used to further enhance the protection of residents and staff and to ensure transparency in the use of funds. Newfoundland and Labrador will amend its action plan by December 1, 2021 to provide information with respect to those privately-owned for-profit facilities benefiting from the federal investments, including confirming that cost-recovery agreements are in place and the amount to be recovered. In addition, Newfoundland and Labrador will provide information on how it will invest funds recovered through the cost-recovery agreements in infection protection and control, in keeping with this program.
• Newfoundland and Labrador will amend its performance measurement section of the action plan by December 1, 2021 and will further update this section by March 31, 2022 to provide information on results, with a view to show casing to Canadians the progress achieved to protect vulnerable Canadians in long-term care settings through its initiatives for increased infection prevention and control.

This Letter of Agreement sets out Newfoundland and Labrador's action plan (Annex 2 to the Agreement) which provides information on the initiatives, expenditures, expected results and performance metrics on the initiatives supported by the Safe Long-term Care funding.

Except as set out in the appendices to this Letter of Agreement, the terms of the Bilateral Agreement will remain in effect.

This Letter of Agreement to amend the Bilateral Agreement will be effective upon both of our respective signatures and, as per the Agreement, will remain in effect until March 31, 2022, unless otherwise terminated by the parties to the Agreement. It, along with the updated Agreement and annexes, will be made public online by Health Canada.

The Honourable John Haggie, Newfoundland and Labrador Minister of Health and Community Services
July 22, 2021

The Honourable Andrew Furey, Premier, Newfoundland and Labrador Minister for Intergovernmental Affairs
July 22, 2021

The Honourable Patty Hajdu, Federal Minister of Health
July 28, 2021