Canada-New Brunswick agreement to Work Together to Improve Health Care for Canadians (2023-24 to 2025-26)

Tables of contents

• Funding agreement
• Annex 1 - Common statement of principles on shared health priorities
• Annex 2 - Shared pan-Canadian interoperability roadmap
• Annex 3 - Headline common indicators
• Annex 4 - Action plan

Funding agreement

(the "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 the 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 NEW BRUNSWICK (hereinafter referred to as "New Brunswick" or "Government of New Brunswick") as represented by the Minister of Health and the Minister responsible for Addictions and Mental Health Services (herein referred to as "the provincial Ministers")

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

PREAMBLE

WHEREAS,on February 23, 2023, Canada and New Brunswick announced an overarching agreement in principle on Working Together to Improve Health Care for Canadians, supported by almost $200 billion over ten years in federal funding, including $46.2 billion in new funding to provinces and territories;

WHEREAS,Working Together to Improve Health Care for Canadians includes a federal commitment of $25 billion in bilateral funding to provinces and territories over ten years focused on four shared health priorities:

• expanding access to family health services, including in rural and remote areas;
• supporting our health workers and reducing backlogs;
• improving access to quality mental health, substance use, and addictions services; and
• modernizing health systems with health data and digital tools.

WHEREAS, in the area of mental health, substance use, and addictions services, Working Together to Improve Health Care for Canadians also includes a commitment by Canada and New Brunswick to continue to work to support collaboration on the Common Statement of Principles on Shared Health Priorities (hereinafter referred to as the "Common Statement", attached hereto as Annex 1), supported by the federal Budget 2017 investment of $5 billion over ten years;

WHEREAS,New Brunswick makes ongoing and significant investments in health consistent with its broader responsibility for delivering health care services to its residents and in supporting diversity, equity, and the needs of underserved and/or disadvantaged populations, including, but not limited to First Nations, Inuit and Métis, official language minority communities, rural and remote communities, children, racialized communities (including Black Canadians), and LGBTIQA2S+;

WHEREAS, Canada authorized the federal Ministers to enter into agreements with the provinces and territories, for the purpose of identifying activities that provinces and territories will undertake in respect of the four shared health priorities, and for funding in this Agreement associated with the federal investment for mental health, substance use, and addictions services consistent with the Common Statement (and menu of actions outlined in Annex 1);

WHEREAS, the Regional Health Authorities Act (R.S.N.B. 2011, c. 217) authorized the provincial Ministers to enter into agreements with the Government of Canada under which Canada undertakes to provide funding toward costs incurred by the Government of New Brunswick associated with the federal investment for four shared health priorities, and mental health, substance use and addictions services consistent with the Common Statement; and

NOW THEREFORE, this Agreement sets out the terms betweenCanada and New Brunswick as follows:

1.0 Key principles and collaboration

The key principles and commitment to collaboration agreed to in Working Together to Improve Health Care for Canadians are outlined below.

1.1 Canada and New Brunswick acknowledge that this Agreement will mutually respect each government's jurisdiction, and be underpinned by key principles, including:

• A shared responsibility to uphold the Canada Health Act that strengthens our public health care system;
• Principles agreed to in the Common Statement (outlined in Annex 1);
• Reconciliation with Indigenous Peoples, recognizing their right to fair and equal access to quality and culturally safe health services free from racism and discrimination anywhere in Canada, including through seamless service delivery across jurisdictions and meaningful engagement and work with Indigenous organizations and governments; and
• Equity of access for under-served groups and individuals, including those in official language minority communities.

1.2 Canada and New Brunswick acknowledge the importance of supporting health data infrastructure, data collection and public reporting, and will work together to improve the collection, sharing and use of de-identified health information, respecting federal/provincial/territorial privacy legislation, to improve transparency on results and to help manage public health emergencies, and to ensure Canadians can access their own health information and benefit from it being shared between health workers across health settings. This includes:

• collecting and securely sharing high-quality, comparable information needed to improve services to Canadians, including disaggregated data on key common health indicators with the Canadian Institute for Health Information (CIHI);
• adopting common interoperability standards (both technical exchange and content of data), including the Shared pan-Canadian Interoperability Roadmap (outlined in Annex 2), to improve Canadians' access to their health information in a usable digital format and support the exchange and analysis of health data within and across Canada's health systems in a way that protects Canadians' privacy and ensures the ethical use of data to improve the health and lives of people;
• work to align provincial and territorial policies and legislative frameworks where necessary and appropriate to support secure patient access to health information, and stewardship of health information to support the public good, including improving care quality, patient safety, privacy protection, system governance and oversight, planning and research;
• promoting health information as a public good by working with federal-provincial-territorial Ministers of Health to review and confirm overarching principles, which would affirm Canadians' ability to access their health information and have it follow them across all points of care. The existing draft Health Data Charter, as outlined in the Pan-Canadian Health Data Strategy would serve as the starting point for the discussion of these principles; and
• collecting and sharing available public health data (e.g., vaccination data, testing data) with the Public Health Agency of Canada to support Canada's preparedness and response to public health events, building on commitments made as part of the Safe Restart Agreements.

1.3 Canada and New Brunswick acknowledge they will work with other provinces and territories to streamline foreign credential recognition for internationally-educated health professionals, and to advance labour mobility, starting with multi-jurisdictional recognition of health professional licences

1.4 Canada and New Brunswick acknowledge a mutual intent to engage in a two-phased formal review process:

1. Phase 1: This review will be done in 2026 by a joint committee of Federal, Provincial, and Territorial health and finance officials to assess results and determine next steps for bilateral agreements related to improvements to home and community care, mental health, substance use, and addiction services associated with the Common Statement and long-term care; and
2. Phase 2: A formal five-year review of the healthcare plan outlined on February 7, 2023, recognizing the importance of long-term sustainability for provincial-territorial health systems. This review would consist of an assessment of both the bilateral agreements (herein) and the CHT investments (not included as part of this bilateral agreement). The review will be done by a joint committee of Federal, Provincial, and Territorial health and finance officials, commencing by March 31, 2027, and concluded by December 31, 2027, to consider results achieved thus far in the four shared health priority areas and will include:
   1. an assessment of progress-to-date on public reporting to Canadians using the common indicators;
   2. sharing of de-identified health information, and other health data commitments; and
   3. current and forward-looking Federal, Provincial, and Territorial investments to support this plan.

2.0 Objectives

2.1 Canada and New Brunswick agree that, with financial support from Canada, New Brunswick will continue to build and enhance health care systems towards achieving some or all of the objectives of:

• timely access to high-quality family health services, including in rural and remote areas;
• a sustainable, efficient and resilient health workforce that provides Canadians timely access to high-quality, effective, and safe health services;
• access to timely, equitable, and quality mental health, substance use, and addictions services to support Canadians' well-being; and
• access to a patient's own electronic health information that is shared between the health professionals they consult to improve safety and quality of care, and which informs Canadians on how the system is working.

2.2 Canada and New Brunswick agree that, with Budget 2017 financial support from Canada outlined in 5.2.2, New Brunswick will continue to work to improve access to mental health, substance use, and addictions services consistent with the Common Statement (and menu of actions outlined in Annex 1).

3.0 Action plan

3.1 New Brunswick set out in their Action Plan (attached as Annex 4) how the federal investment under this Agreement will be used, as well as details on targets and timeframes based on common headline indicators in priority areas where federal funds will be invested, as well as jurisdiction-specific indicators, for each of the initiatives.

3.2 New Brunswick will invest federal funding as part of the 2017 commitment for mental health, substance use, and addictions services provided through this Agreement in alignment with the menu of actions listed in the Common Statement.

3.3 New Brunswick will invest federal funding in some or all of the four shared health priority areas, without displacing existing planned spending in those areas.

3.4 In developing initiatives under this Agreement, New Brunswick agrees to implement measures that also respond to the needs of underserved and/or disadvantaged populations, including, but not limited to First Nations, Inuit and Métis, official language minority communities, rural and remote communities, children, racialized communities (including Black Canadians), and LGBTIQA2S+.

3.5 New Brunswick's approach to achieving objectives is set out in their three-year Action Plan (2023-24 to 2025-26), as set out in Annex 4.

4.0 Term of agreement

4.1 This Agreement comes into effect upon the date of the last signature of the Parties and will remain in effect until March 31, 2026 ("the Term"), unless terminated in accordance with section 11 of this Agreement. Funding provided under this Agreement will cover the period April 1, 2023 to March 31, 2026.

4.2 Renewal of bilateral agreements

4.2.1 Upon signing renewed bilateral agreements, New Brunswick will have access to the remainder of its share of the federal funding, subject to appropriation by Parliament, for:

• 2026-27, the allocation based on the federal commitment in Budget 2017 of $5 billion over ten years for mental health, substance use and addiction services; and
• 2026-27 to 2032-33, the allocation based on the federal commitment in Budget 2023 of $25 billion over ten years to support the Working Together to Improve Health Care for Canadians plan.

5.0 Financial provisions

5.1 The funding provided under this Agreement is in addition to and not in lieu of those that Canada currently provides under the CHT to support delivering health care services within the province.

5.2 Allocation to New Brunswick

5.2.1 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.

5.2.2 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 5.2.3 for the Term of this Agreement.

Working Together to Improve Health Care for Canadians

1. $2.5 billion for the Fiscal Year beginning on April 1, 2023
2. $2.5 billion for the Fiscal Year beginning on April 1, 2024
3. $2.5 billion for the Fiscal Year beginning on April 1, 2025

Budget 2017 Mental Health, Substance Use, and Addictions Services

1. $600 million for the Fiscal Year beginning on April 1, 2023
2. $600 million for the Fiscal Year beginning on April 1, 2024
3. $600 million for the Fiscal Year beginning on April 1, 2025

5.2.3 Allocation method

1. For the funding associated with Working Together to Improve Health Care for Canadians, annual funding will be allocated to provinces and territories on base ($5,000,000 if population is less than 100,000; $20,000,000 if population is between 100,000 and 500,000; and $50,000,000 if population is greater than 500,000) plus per capita basis. The final total amount to be paid to each jurisdiction will be calculated using the following formula: B + (F - ((N * 5,000,000) + (O * 20,000,000) + (S * 50,000,000)) x (K / L), where:

   B is the base amount allocated to each province or territory based on population ($5,000,000 if population is less than 100,000; $20,000,000 if population is between 100,000 and 500,000; and $50,000,000 if population is greater than 500,000), as determined using annual population estimates on July 1^st from Statistics Canada;

   Fis the total annual funding amount available outlined under this program;

   N is the number of provinces and territories with a population less than 100,000, as determined using annual population estimates on July 1^st from Statistics Canada;

   O is the number of provinces and territories with a population between 100,000 and 500,000, as determined using annual population estimates on July 1^st from Statistics Canada;

   Sis the number of provinces and territories with a population greater than 500,000, as determined using annual population estimates on July 1^st from Statistics Canada;

   K is the total population of New Brunswick, as determined using annual population estimates on July 1^st from Statistics Canada; and

   Lis the total population of Canada, as determined using annual population estimates on July 1^st from Statistics Canada.

2. For funds associated with Budget 2017 Mental Health, Substance Use, and Addictions Services, annual funding will be allocated to provinces and territories on a per capita basis. The per capita funding for each Fiscal Year, is calculated using the following formula: F x K/L, where:

   F is the annual total funding amount available under this program;

   K is the total population of New Brunswick, as determined using the annual population estimates on July 1^st from Statistics Canada; and

   L is the total population of Canada, as determined using the annual population estimates on July 1^st from Statistics Canada.

5.2.4 Subject to annual adjustment based on the formulas described in section 5.2.3, New Brunswick estimated share of the amounts will be:

Fiscal Year	Working Together to Improve Health Care for Canadians Estimated amount to be paid to New BrunswickFootnote * (subject to annual adjustment)	Budget 2017 Mental Health, Substance Use, and Addictions Services Estimated amount to be paid to New BrunswickFootnote * (subject to annual adjustment)
2023-2024	$92,030,000	$12,520,000
2024-2025	$92,030,000	$12,520,000
2025-2026	$92,030,000	$12,520,000
Footnote * Table 1 Footnote Amount represent annual estimates based on Statistics Canada's July 1st, 2022, population estimates. Return to footnote * referrer

5.3 Payment

5.3.1 Funding provided by Canada will be paid in semi-annual installments as follows:

1. In 2023-2024, the first installment will be paid within approximately 30 business days of execution of this Agreement by the Parties. The second installment will also be paid within approximately 30 business days of execution of this Agreement by the Parties, subject to 5.3.1.g.
2. Starting in 2024-2025, the first installment will be paid on or about April 15 of each Fiscal Year and the second installment will be paid on or about November 15 of each Fiscal Year.
3. The first installment will be equal to 50% of the notional amount set out in section 5.2.4 as adjusted by section 5.2.3.
4. The second installment will be equal to the balance of funding provided by Canada for the Fiscal Year as determined under sections 5.2.3 and 5.2.4.
5. Canada will notify New Brunswick prior to the first payment of each Fiscal Year, of their notional amount. The notional amount will be based on the Statistics Canada quarterly preliminary population estimates on July 1 of the preceding Fiscal Year. Prior to the second payment, Canada will notify New Brunswick of the amount of the second installment as determined under sections 5.2.3 and 5.2.4.
6. Canada shall withhold payments if New Brunswick has failed to provide reporting in accordance with 7.1.
7. Canada shall withhold the second payment in 2023-24 if New Brunswick has failed to satisfy all reporting requirements associated with the preceding Canada - New Brunswick Home and Community Care and Mental Health and Addictions Services Funding Agreement 2022-23, specifically to:
   1. continue to participate in a Federal-Provincial-Territorial process to improve reporting on and provide data to CIHI for the 6 common indicators to measure pan-Canadian progress on improving access to mental health, substance use, and addictions services; and
   2. submit an annual financial statement, with attestation from the Department of Health's Executive Director, Financial Services, of funding received the preceding Fiscal Year from Canada for mental health and addiction services under the Canada - New Brunswick Home and Community Care and Mental Health and Addictions Services Funding Agreement 2022-23 compared against the Expenditure Plan, and noting any variances, between actual expenditures and the Expenditure Plan.
8. The sum of both installments constitutes a final payment and is not subject to any further payment once the second installment has been paid.
9. Payment of Canada's funding for this Agreement is subject to an annual appropriation by the Parliament of Canada for this purpose.

5.4 Retaining funds

5.4.1 For Fiscal Years 2023-24 through 2024-25, upon request, New Brunswick may retain and carry forward to the next Fiscal Year up to 10 percent of funding that is in excess of the amount of the eligible costs actually incurred in a Fiscal Year and use the amount carried forward for expenditures on eligible areas of investment. Any request to retain and carry forward an amount exceeding 10 percent will be subject to discussion and mutual agreement in writing by their designated officials, at the Assistant Deputy Minister level (herein referred to as "Designated Officials"), and is subject to monitoring and reporting to Canada on the management and spending of the funds carried forward on a quarterly basis.

5.4.2 Any amount carried forward from one Fiscal Year to the next under this subsection is supplementary to the maximum amount payable to New Brunswick under subsection 5.2.4 of this Agreement in the next Fiscal Year.

5.4.3 Upon request, New Brunswick may retain and carry forward up to 10 percent of funding provided in the last Fiscal Year of this Agreement for eligible areas of investment, to be noted in the new agreement and subject to the terms and conditions of that new agreement. Any request by New Brunswick to retain and carry forward an amount exceeding 10 percent will be subject to discussion and mutual agreement in writing by their Designated Officials, and is subject to monitoring and reporting to Canada on the management and spending of the funds carried forward on a quarterly basis.

5.5 Repayment of overpayment

5.5.1. In the event payments made exceed the amount to which New Brunswick 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, New Brunswick shall repay the amount within sixty (60) calendar days of written notice from Canada.

5.6 Use of funds

5.6.1. The Parties agree that funds provided under this Agreement will only be used by New Brunswick in accordance with the initiatives outlined in Annex 4.

5.7 Eligible expenditures

5.7.1. Eligible expenditures under this Agreement are the following:

• data development and collection to support reporting;
• information technology and health information infrastructure;
• capital and operating funding;
• salaries and benefits;
• training, professional development; and
• information and communications material related to programs.

6.0 Performance measurement

6.1 New Brunswick agrees to designate an official or official(s), for the duration of this Agreement to participate in a CIHI led Federal-Provincial-Territorial indicator process to:

1. Refine the eight common headline indicators (outlined in Annex 3);
2. Work to identify additional common indicators that are mutually agreed upon, including indicators focused on the health of Indigenous populations with acknowledgement of the role for Indigenous partners in this work;
3. Improve reporting on common indicators to measure pan-Canadian progress on improving access to mental health, substance use, and addictions services, associated with the commitment in the Common Statement; and
4. Share available disaggregated data with CIHI and work with CIHI to improve availability of disaggregated data for existing and new common indicators to enable reporting on progress for underserved and/or disadvantaged populations including, but not limited to, Indigenous peoples, First Nations, Inuit, Métis, official language minority communities, rural and remote communities, children, racialized communities (including Black Canadians), and LGBTIQA2S+.

7.0 Reporting to Canadians

7.1 Funding conditions and reporting

7.1.1 By no later than October 1, in each fiscal year, with respect of the previous Fiscal Year, New Brunswick agrees to:

1. Provide data and information annually to CIHI related to the new headline indicators, additional common indicators, and the mental health, substance use, and addictions services indicators identified as part of commitment made in the Common Statement.
2. Beginning in Fiscal Year 2024-25,report annually and publicly in an integrated manner to residents of New Brunswick on progress made on targets outlined in Annex 4 (Action Plan) for headline indicators in the priority area(s) where federal funds are to be invested, and on jurisdiction-specific indicators for each of the initiatives tailored to their jurisdiction's needs and circumstances.
3. Beginning in Fiscal Year 2024-25, provide to Canada an annual financial statement, with attestation from the Department of Health's Executive Director, Financial Services, 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 each of the shared health priority areas that are supported by the federal funds;
   3. If applicable, the amount of any funding carried forward under section 5.4; and
   4. If applicable, the amount of overpayment that is to be repaid to Canada under section 5.5.

7.1.2 New Brunswick will provide quarterly reporting to Canada on the management and spending of the funds retained to the next Fiscal Year.

7.2 Audit

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

7.3 Evaluation

7.3.1 Responsibility for evaluation of programs rests with New Brunswick in accordance with its own evaluation policies and practices.

8.0 Communications

8.1 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.

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

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

8.4 New Brunswick will make publicly available, clearly identified on a Government of New Brunswick website, this agreement, including any amendments.

8.5 Canada, with prior notice to New Brunswick, may incorporate all or any part of the data and information in 7.1, or any part of evaluation and audit reports made public by New Brunswick 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.

8.6 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 New Brunswick 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.

8.7 New Brunswick reserves the right to conduct public communications, announcements, events, outreach and promotional activities about the Common Statement and this Agreement. New Brunswick 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.

8.8 Canada and New Brunswick agree to participate in a joint announcement upon signing of this Agreement.

8.9 Canada and New Brunswick agree to work together to identify mutually agreeable opportunities for joint announcements relating to programs funded under this Agreement.

9.0 Dispute resolution

9.1 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.

9.2 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.

9.3 If a dispute cannot be resolved by Designated Officials, then the dispute will be referred to the Deputy Ministers of Canada and New Brunswick 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.

10.0 Amendments to the agreement

10.1 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 New Brunswick, by the provincial Minister(s).

10.2 Annex 4 may be amended at any time by mutual consent of the Parties. Any amendments to Annex 4 shall be in writing and signed by each Party's Designated Official.

11.0 Termination

11.1 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.

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

11.3 Sections 1.0, and 8.0 of this Agreement survive for the period of the 10-year Working Together to Improve Health Care for Canadians plan.

11.4 Sections 5.4 and 7.0 of this Agreement survive the termination or expiration of this Agreement until reporting obligations are completed.

12.0 Notice

12.1 Any notice, information, or document provided for under this Agreement will be effectively given if delivered or sent by letter, 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 of the Designated Official for Canada shall be:

Assistant Deputy Minister, Strategic Policy Branch
Health Canada
70 Colombine Driveway
Brooke Claxton Building
Ottawa, Ontario
K1A 0K9
Email: jocelyne.voisin@hc-sc.gc.ca

The address of the Designated Official for New Brunswick shall be:

Assistant Deputy Minister, Corporate Services
New Brunswick Department of Health
HBSC Place
P.O. Box 5100
Fredericton, New Brunswick
E3B 5G8
Email: Lee.Burry@gnb.ca

13.0 General

13.1 This Agreement, including Annexes, comprises the entire Agreement entered into by the Parties.

13.2 This Agreement shall be governed by and interpreted in accordance with the laws of Canada and New Brunswick.

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

13.4 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.

13.5 This Agreement may be executed in counterparts, in which case (i) the Parties have caused this Agreement to be duly signed by the undersigned authorized representatives in separate signature pages in accordance with the following signature process, which together shall constitute one agreement, and (ii) the Parties agree that facsimile signature(s) and signature(s) transmitted by PDF shall be treated as original signature(s). Electronic signature(s) may be accepted as originals so long as the source of the transmission can be reasonably connected to the signatory.

IN WITNESS WHEREOF the Parties have executed this Agreement through duly authorized representatives.

SIGNED on behalf of Canada by the Minister of Health
The Honourable Mark Holland, Minister of Health

IN WITNESS WHEREOF the Parties have executed this Agreement through duly authorized representatives.

SIGNED on behalf of Canada by the Minister of Mental Health and Addictions and Associate Minister of Health
The Honourable Ya'ara Saks, Minister of Mental Health and Addictions and Associate Minister of Health

IN WITNESS WHEREOF the Parties have executed this Agreement through duly authorized representatives.

SIGNED on behalf of New Brunswick by the Minister of Health
The Honourable Bruce Fitch, Minister of Health

IN WITNESS WHEREOF the Parties have executed this Agreement through duly authorized representatives.

SIGNED on behalf of New Brunswick by the Minister responsible for Addictions and Mental Health
The Honourable Sherry Wilson, Minister responsible for Addictions and Mental Health

Annex 1 - Common Statement of Principles on Shared Health Priorities

Common Statement of Principles on Shared Health Priorities

Annex 2 - Shared pan-Canadian interoperability roadmap

Figure 1 - Text description

5-Year Shared Pan-Canadian Interoperability Roadmap

The Roadmap outlines 8 categories of activities planned for fiscal years 2023 to 2027, followed by anticipated outcomes enabled. Notes are also included throughout to highlight a "milestone", where "vendor input is required", and/or when an activity is "continued" across multiple fiscal years.

Patient Summary

• Fiscal Year 2023
  • Alberta & Ontario Trial Implementation & onboard 2-3 Jurisdictions
  • Update based on Trial Implementations
  • Update and publish the Canadian Health Data Exchange (CA:FeX) Specification
• Fiscal Year 2024
  • Update specification to fully align to IPS/CA Core+ and reflect implementation feedback
  • Onboard remaining jurisdictions
  • Publish vendor conformance requirements and represent in national procurements [vendor input required]
• Fiscal Year 2025
  • Advance implementation and adoption
  • Pan-Canadian vendor compliance service *(Pan-Canadian interoperability compliance testing service in place, vendors conform to pan-Canadian standards in stages.) [vendor input required]
• Fiscal Year 2026
  • Advance implementation and adoption [continued]
  • Conduct performance evaluation
  • Update specification to reflect updated CA Core+ [milestone]
• Fiscal Year 2027
  • Advance implementation and adoption [continued]
  • Conduct performance evaluation [continued]

Data Portability

• Fiscal Year 2023
  • Develop Primary Care Dataset V1 & EMR Extract Specification V1 [milestone]
  • Represent Data Portability components in the Canadian Health Data Exchange (CA:FeX) Specification
• Fiscal Year 2024
  • Trial Implementation of specifications
  • Extend CA Core+ to include other settings (e.g. Acute Care, Mental Health)
• Fiscal Year 2025
  • Expand adoption and refinement to include LTC, Community Care and implementation feedback
  • Include requirements in national procurements (e.g. Acute Care, LTC, Mental Health, Community Care)
• Fiscal Year 2026
  • Expand adoption of Specifications
  • Complete specifications [milestone]
  • Pan-Canadian vendor compliance service *(Pan-Canadian interoperability compliance testing service in place, vendors conform to pan-Canadian standards in stages.) [vendor input required]
  • Conduct performance evaluation
• Fiscal Year 2027
  • Expand adoption of Specifications [continued]
  • Conduct performance evaluation [continued]

Patient Access

• Fiscal Year 2023
  • Assess patient data and access needs across jurisdictions
  • Assess the feasibility of IPA standard and decide on Canadian adoption of same
• Fiscal Year 2024
  • Co-design patient data access design/Blueprint to represent policy and consent in alignment with IPA
  • Implementation and refinement of the Canadian Health Data Exchange Specification to include Patient Access components [milestone]
• Fiscal Year 2025
  • Update data exchange specification to support patient Digital Identities
  • Expand adoption of Canadian Health Data Exchange Specification
• Fiscal Year 2026
  • Develop pan-Canadian guidance documentation for basic digital consent
  • Expand adoption of Canadian Health Data Exchange Specification [continued]
  • Conduct performance evaluation
• Fiscal Year 2027
  • Develop advanced guidance documentation to integrate policy and consent into data access
  • Expand adoption of Canadian Health Data Exchange Specification [continued]
  • Conduct performance evaluation [continued]

eReferral & eConsult

• Fiscal Year 2023
  • Consolidate existing specifications and publish pan-Canadian specification with procurement requirements [milestone]
• Fiscal Year 2024
  • Publish conformance requirements for vendors [vendor input required]
  • Implementation of pan-Canadian specifications
• Fiscal Year 2025
  • Evolve specification to integrate other services (e.g. PS-CA. Provider Directories and Digital Identities)
  • Pan-Canadian vendor compliance service *(Pan-Canadian interoperability compliance testing service in place, vendors conform to pan-Canadian standards in stages.) [vendor input required]
• Fiscal Year 2026
  • Complete Specification [milestone]
  • Conduct performance evaluation [continued]
• Fiscal Year 2027
  • Conduct performance evaluation [continued]

Enablers

• Fiscal Years 2023 to 2027
  • Governance
  • Change Management
  • Vendor Mobilization

Data

• Fiscal Year 2023
  • p-CHDCF, CA Core+ and Consistent Data Semantics
  • Data Matching
• Fiscal Year 2024
  • p-CHDCF, CA Core+ and Consistent Data Semantics [continued]
  • Data Matching [continued]
• Fiscal Year 2025
  • p-CHDCF, CA Core+ and Consistent Data Semantics [continued]
  • Data Matching [continued]
• Fiscal Year 2026
  • p-CHDCF, CA Core+ and Consistent Data Semantics [continued]
• Fiscal Year 2027
  • N/A

Access & Exchange

• Fiscal Year 2023
  • Consistent, Secure, HIE Exchange
  • Healthcare Directories and Resource Locations
• Fiscal Year 2024
  • Consistent, Secure, HIE Exchange [continued]
  • Provider Directories
  • Digital Identities & Identity Proofing
  • Healthcare Directories and Resource Locations [continued]
• Fiscal Year 2025
  • Consistent, Secure, HIE Exchange [continued]
  • Provider Directories [continued]
  • Digital Identities & Identity Proofing [continued]
  • Healthcare Directories and Resource Locations [continued]
• Fiscal Year 2026
  • Consistent, Secure, HIE Exchange [continued]
  • Provider Directories [continued]
  • Digital Identities & Identity Proofing [continued]
  • Consistent Patient Access
  • Healthcare Directories and Resource Locations [continued]
• Fiscal Year 2027
  • Consistent, Secure, HIE Exchange [continued]
  • Consistent Patient Access [continued]

Trusted Framework

• Fiscal Year 2023
  • Jurisdictional Needs Assessment [milestone]
  • Scalable Data Sharing Governance Framework
  • Industry-wide, Testing and Conformance
• Fiscal Year 2024
  • TEF development (contingent on PT support)
  • Scalable Data Sharing Governance Framework [continued]
  • Industry-wide, Testing and Conformance [continued]
• Fiscal Year 2025
  • Consistent Representation of Policy & Consent
  • Scalable Data Sharing Governance Framework [continued]
  • Industry-wide, Testing and Conformance [continued]
• Fiscal Year 2026
  • Consistent Representation of Policy & Consent [continued]
  • Scalable Data Sharing Governance Framework [continued]
  • Industry-wide, Testing and Conformance [continued]
• Fiscal Year 2027
  • Consistent Representation of Policy & Consent [continued]
  • Scalable Data Sharing Governance Framework [continued]
  • Industry-wide, Testing and Conformance [continued]

Outcomes

• Ability to import/export primary care data to, from and between EMRs
• Clinicians able to change EMRs
• Governance model established
• Vendor support services available to all jurisdictions
• National procurement framework established
• Change management program in place
• 50% of Canadians enabled to directly access their longitudinal record
• 60% of primary care physicians reporting ability to exchange patient summary record
• 70% of clinicians with EMRs enabled to send clinical summaries through a vendor conformed solution
• 75% of Canadians enabled to access their patient summary record
• Benefits realized:
  • Health System - $500M in improved interactions, effective use of ED, in-patient services, an reduction in duplicate tests
  • Canadians - over $500M in saved patient time
  • Clinicians - over $350M in saved time

Annex 3 - Headline common indicators

Shared health priority area	Indicator
Family health services	Percentage of Canadians who report having access to a regular family health team, a family doctor or nurse practitioner, including in rural and remote areas
Health workers and backlogs	Size of COVID-19 surgery backlog
	Net new family physicians, nurses, and nurse practitioners
Mental health and substance use	Median wait times for community mental health and substance use services
	Percentage of youth aged 12 to 25 with access to integrated youth services (IYS) for mental health and substance use
	Percentage of Canadians with a mental disorder who have an unmet mental health care need
Modern health data system	Percentage of Canadians who can access their own comprehensive health record electronically
	Percentage of family health service providers and other health professionals (e.g., pharmacists, specialists, etc.) who can share patient health information electronically

Annex 4 - Action plan

I. Context and current status

Introduction

Ensuring the long-term sustainability of New Brunswick's health care system requires innovative delivery, strategic investments, and a healthier population. This is not unique. The challenges New Brunswick is experiencing are persistent in all provinces and territories and indeed, across the globe.

Citizens are waiting a long time for tests and surgeries, hospitals are experiencing unexpected closures, and staff shortages are common. The pandemic added significant pressure. The need to act immediately, to stabilize the system and prevent further deterioration of services, is imperative. Health care in New Brunswick is a collection of silos that often operate independently. People, technology, and information are not connected in the ways they need to be to focus on the citizen and deliver better services to New Brunswickers. Health care must evolve.

In November 2021, the New Brunswick government unveiled its new health plan, Stabilizing Health Care: An Urgent Call to Action, a five-year "evergreen" road map for evolving health care in New Brunswick to address these challenges. The plan outlines a path forward, intended to stabilize and rebuild New Brunswick's health-care system to be more citizen-focused, accessible, accountable, inclusive, and service-oriented.

The plan, Stabilizing Health Care: An Urgent Call to Action includes five action areas, including:

• Access to primary health care
• Access to surgery
• Create a connected system
• Access to addiction and mental health service
• Support seniors to age in place

The plan includes substantial changes that New Brunswickers have already experienced and will continue to see over the next few years to stabilize and rebuild the health-care system.

Access to primary care is improving. We have given New Brunswick pharmacists the ability to assess and prescribe for 11 common ailments and services. Emergency rooms have seen improvements and with that, reductions in their wait times. The number of people waiting more than a year for hip and knee surgeries have gone from 700 in 2022 to now less than 400. This time next year, no one will wait longer than 12 months for hip or knee replacement surgery.

We have launched a recruitment campaign directed at health professionals through nbhealthjobs.ca. Since June 2022, we have seen net increases in RNs, LPNs, and PSWs, and we have seen a net gain, in the last fiscal year, to the number of physicians in the province.

We have boosted our mental health resources and assigned staff to ERs so that people experiencing an addiction or mental health crisis receive more timely support. We have introduced one-at-a-time therapy reducing the adult mental health wait list.

We are also reducing financial barriers for internationally educated nurses by covering various costs associated with nurses becoming eligible to work in the province.

These are just a few of the many accomplishments to date.

While much has been achieved, there is still much more that needs to be done. Significant investments are required to continue to obtain the goals that have been set. Accordingly, the New Brunswick 2023/2024 $3.58-billion budget for health-care services represented an increase of $344.7 million, which includes approximately $92M in new federal funding, as well as approximately $12.5M in previously committed federal funding for mental health and addiction services associated with the 2017 Common Statement of Principles on Shared Health Priorities (CSOP). This 10.6% increase in the overall budget is the largest in more than two decades, one of the biggest our province has ever seen.

New bilateral funding through the federal government's Working Together to Improve Health Care for Canadians plan will be incremental to the funding support New Brunswick will invest to advance the priorities in our provincial health plan. This will be done through federal investments across the four shared health priorities outlined in Section II of this action plan.

The Government of New Brunswick is committed to actively offering and providing quality health care services to the public in the Public's official language of choice. New Brunswick takes its linguistic obligations into account in the delivery of health care services throughout the province. In fact, the provincial health plan includes the notion of respect for official languages among its basic principles, pursuant to the obligations set out in New Brunswick's Official Languages Act, and An Act Recognizing the Equality of the Two Official Linguistic Communities in New Brunswick.

New Brunswick acknowledges that the health disparities experienced by Indigenous peoples can be attributed to the legacy of colonialism, and the resulting cultural, economic, and social disadvantage.

We remain committed to partnering with Indigenous peoples in New Brunswick in efforts to close these gaps and advance reconciliation. Our objective is to ensure all New Brunswick residents will live with equity of opportunity and treatment, in a context which is culturally respectful, and free from discrimination or racism.

To advance this commitment, New Brunswick has implemented policies and mandatory cultural sensitivity / anti-racism training for all health care staff. New Brunswick has also partnered with Indigenous communities and organizations to develop a large portfolio of Indigenous-led initiatives specifically to improve Indigenous health outcomes. These actions include primary care, acute care, public health, mental health and addictions services, home health care, and cancer screening. They are set within a context of seeking cultural sensitivity, and the identification and eradication of unconscious bias.

A small sample of these initiatives include work to enhance culturally safe practices in acute care facilities ( e.g., Smudging Policy, Access to Sacred Medicine), a comprehensive plan to improve Indigenous peoples' cancer experiences and outcomes from early screening through acute care (Kmawuhsahtipon - Togi pematioog - Moving Forward Side-by-Side initiative), and initial steps towards the development of a New Brunswick Indigenous Administrative Health Data Identifier Standard to build Indigenous control and use of their own health data.

While the impact of such individual programs is substantial, their full impact will be realized and magnified as the principles they embody become normalized and embedded within the full scope of services the health system offers.

II. Shared health priorities and description of initiatives

Family Health Services

Strong primary health care is critical to ensuring that citizens can get the health care they need at the right time, in the right place, and by the right provider. It is fundamental to helping citizens and their families better manage health conditions and to reducing pressures on more expensive and resource-intensive acute care service.

New Brunswick faces many challenges including long wait lists, an outdated model for primary health care, and aging physicians. Today, less than 30,000 citizens are on the Patient Connect NB list. The list is evergreen and will be further challenged near-term as New Brunswick physicians age and over time as the province pursues new population growth.

Further complicating service levels is the fact that New Brunswick is operating with an outdated model of solo practitioners. Almost 55 per cent of New Brunswick's doctors work in a solo practice, the highest percentage in Canada. This means they have no one to cover for them when they are on call, resting after an overnight shift in the emergency department, on vacation or even when they are sick.

About 35 per cent of New Brunswick's family doctors will be eligible for retirement within five years and younger physicians entering practice are interested in working in teams with enriching peer learning opportunities.

Our provincial health plan emphasizes an evolution to team-based care and combining upstream public health activities with primary health care and addiction and mental health services. No matter where a citizen enters the system - be it a call to 811, visiting a community health centre, going to the emergency department, contacting Public Health or Addiction and Mental Health Services, or contacting a pharmacist - they will be welcomed, accepted, and be connected to the right type of care.

Stabilizing Health Care: An Urgent Call to Action outlines actions to fully address the wait list for accessing primary health care, including:

• Establishing a new provincial Primary Care Network to allow citizens without a family doctor or nurse practitioner to register and receive primary care services until they are matched with a permanent provider;
• Integrating this Primary Care Network with Tele-Care 811 to provide seamless access to a wide range of health services across the New Brunswick population, including for those who already have a family doctor or nurse practitioner but cannot see them in a timely manner;
• Re-organizing community health services with the participation of community leaders, regional health authorities, primary care providers and non-governmental organizations, into care networks. This will make it easier for New Brunswickers to access both virtual and in-person care with clear criteria for what is appropriate depending upon the citizen's needs.

Health Workforce

Ensuring New Brunswickers have enough human resources to provide care now and in the future requires both transformation and investment.

New Brunswick has serious shortages in health-care workers, and is competing not just with neighbouring provinces, but around the world for health-care talent.

About 35 per cent of New Brunswick's family doctors will be eligible for retirement within five years. These doctors will be replaced by younger physicians seeking a greater work-life balance than their predecessors, which includes carrying smaller patient loads than physicians in decades past. This presents a difficulty in a province already challenged to attract and retain physicians, particularly in rural New Brunswick where approximately 72 per cent of physician vacancies exist.

This is further intensified in rural francophone New Brunswick, where 85 per cent of Vitalité's vacancies are found. The current shortage of nurses and other health-care providers predates the pandemic, but the pandemic has made it worse, leading to burnout and early attrition. Currently, over 32 per cent of registered nurses are over the age of 55, with seven per cent over the age of 65.

Stabilizing Health Care: An Urgent Call to Action outlines actions to address these human resource challenges, including:

• Working with New Brunswick's health-care professional regulatory bodies and its post-secondary institutions on three specific goals: developing innovative education and clinical training models; shorter training programs combined with experiential learning; and speeding up the recognition of the foreign qualifications of health professionals trained abroad;
• The regional health authorities, EM/ANB and the Department of Health will work together on a strategy to reduce workplace violence, recognize employee efforts, and promote greater wellness throughout the health-care system;
• Increasingly utilize a variety of non-traditional providers to give citizens more timely access to services.

Backlogs

New Brunswick's population is aging, with nearly 20 per cent more seniors than the rest of Canada. This gap is expected to grow and based on current projections, by the late 2030's nearly one-third of the province's population will be over the age of 65. As citizens age, the number of procedures for hip and knee replacements, and cataract surgeries have been on the rise.

As more procedures are needed, and staff shortages persist, New Brunswick has been falling behind national timelines for hip and knee replacement surgeries. In New Brunswick, only 47 per cent of citizens receive a hip or knee replacement within six months of the time the orthopedic surgeon agrees to operate. On average, 72 per cent of Canadians receive the surgery within six months of being referred.

However, in the last year, excellent progress has been made on improving hip and knee surgery wait times with a 50 per cent reduction in those waiting for over a year. Learnings will be scaled to ensure the backlog from the pandemic is cleared completely and that improvements continue to be made.

Stabilizing Health Care: An Urgent Call to Action outlines actions to address this backlog, including:

• Implementing the Enhanced Recovery After Surgery (ERAS) project for colorectal surgery patients in Moncton, and hip and knee replacement surgery patients in Saint John;
• Empowering citizens to choose the next available orthopedic specialist in their zone or to wait for a specific surgeon through an electronic referral system;
• Avoiding unnecessary face-to-face consultations with specialists via an electronic health record which allows doctors and nurses to ask specialists for advice about a patient;
• Eliminating the list of citizens waiting more than a year for hip and knee replacement surgery;
• Expanding the electronic referral process pilot launched in April 2022 from orthopedic surgery to other specialities province wide.

Mental Health and Substance Use

Over the past five years, the demand for addiction and mental health services has increased 16 per cent. Requests from adults are up nine per cent, while youth service needs are up 33 per cent.

As a result of increased demand, wait times for new high priority referrals have increased and less than 50 per cent are currently receiving treatment within national benchmarks. At the same time, 51 per cent of New Brunswickers have indicated they are at risk of developing negative mental health impacts due to the social isolation, stress, and economic impacts of the unprecedented COVID-19 pandemic. All data suggests the need for supports and services will continue to climb.

Earlier this year the Government of New Brunswick released the Inter-departmental Addiction and Mental Health Action Plan Priority Areas for 2021-2025. This plan is based on a client-centric stepped care model that moves along a continuum from promotion of population health and prevention services all the way up to higher intensity and specialized services. The plan is actively being implemented and over the next 24 months will deliver significant improvements.

With the remaining four years of funding for mental health and addictions services associated with the 2017 Common Statement of Principles on Shared Health Priorities (CSOP), New Brunswick is investing $12.5M in federal funding annually to support the following mental health and addiction services:

1. Enhanced Action Plan on Addictions and Mental Health ($7.5M) - a coordinated approach to the delivery of addictions and mental health services in New Brunswick, including mobile mental health services, training for primary care providers, partnering with First Nations to provide services, and province-wide e-mental health services.
2. Integrated Community Mental Health Care Services for Youth ($5.0M) - a network of excellence, to include 16-beds in two treatment facilities (Campbellton 8 beds, Moncton 8 beds) for youth with complex mental health needs, and the Integrated Service Delivery model for mental health services in school and community settings. Additional federal funding is used to provide training and professional development to multidisciplinary teams established through the ISD initiative, funding integrated service delivery teams customized to the varying needs of each of the First Nation communities throughout New Brunswick.

These two initiatives are consistent with those outlined in the 2018 to 2022 Canada - New Brunswick Home and Community Care and Mental Health and Addictions Services Funding Agreement. More information regarding the specific initiatives supported with this funding can be found at this link: 2018 to 2022 Canada-New Brunswick Home and Community Care and Mental Health and Addictions Services Funding Agreement

Modern Health Data System

Over the next few years, the department will deliver tangible changes that will eventually create a connected system. New Brunswickers deserve a more seamless experience - from having clarity around which services they can access with and without referrals, to undergoing tests for bloodwork and diagnostic imaging. During the pandemic, New Brunswick implemented technology to communicate with citizens and coordinate self-bookings of vaccinations - in just a matter of weeks. New insights were gained about laboratory services and how to test people closer to their homes. Specimens were transported throughout the province with an efficient turnaround time for results, and results were available online for citizens in a timely manner. These successes must be built upon to stabilize health care and start the shift to a preventative health-care model that is supported by healthy communities and empowered citizens.

GNB and Canada Health Infoway (Infoway) will support the implementation of the Shared Pan-Canadian Interoperability Roadmap to advance patient-centred and Connected Care in New Brunswick. By leveraging the collaborative effort that initially launched MyHealthNB, GNB and Infoway will expand patient and clinician access to health information, including in virtual settings, to improve delivery of care and patient health outcomes. Backed by international standards and best practice in digital health delivery, this will include:

• Further modernizing the NB health system to enable the sharing of information between clinicians
• Modernizing the patient experience and developing tools to better support patients to navigate care options seamlessly.
• Continued expansion of MyHealthNB further enable patients to actively participate in their healthcare.
• Accelerating investments in technology and unlocking the value of data to ensure care teams can provide quality patient-centered care to benefit every NB citizen.

III. Funding allocation

Summary action plan

Initiative	Incremental Investment			Total
	2023-24	2024-25	2025-26
Family Health Services	$20.0M	$20.0M	$20.0M	$60.0M
Models of Care	$17.0M	$17.0M	$17.0M	$51.0M
Program Improvements	$3.0M	$3.0M	$3.0M	$9.0M
Health Workforce and Backlogs	$39.7M	$39.7M	$39.7M	$119.1M
Recruitment and Retention	$31.9M	$31.9M	$31.9M	$95.7M
Safety and Wellness	$2.2M	$2.2M	$2.2M	$6.6M
Surgery Backlog Reductions	$5.6M	$5.6M	$5.6M	$16.8M
Mental Health and Substance Use	$2.9M	$2.9M	$2.9M	$8.7M
Mental Health and Addiction Services (CSoP)	$12.5M	$12.5M	$12.5M	$37.5M
Enhanced Action Plan on Addictions and Mental Health	$7.5M	$7.5M	$7.5M	$22.5M
Integrated Community Mental Health Care Services for Youth	$5.0M	$5.0M	$5.0M	$15.0M
Modernizing Health Data System	$29.4M	$29.4M	$29.4M	$88.2M
Strengthening Access to Patient Care	$9.7M	$9.7M	$9.7M	$29.1M
System Improvements	$19.7M	$19.7M	$19.7M	$59.1M
Total	$104.5M	$104.5M	$104.5M	$313.5M
Total Federal Funding Available	$104.5M	$104.5M	$104.5M	$313.5M

IV. Measuring and reporting on results

Table IV.1: Common Headline Indicators as outlined in CIHI's report, "Taking the pulse: A snapshot of Canadian health care, 2023"

Indicator	Baseline	Target	Timeframe
Family Health Services
Percent of New Brunswickers aged 12 and over who report having a regular health care provider	89.9%	90.9%	March 2026
Health Workers and Backlogs
Size of COVID-19 surgery backlog (%)	-13%	0%	March 2026
Supply of (per 10K population)
family physicians	14	14.25	March 2026
nurses	101.8	103	March 2026
nurse practitioners	2	2.1	March 2026
Mental Health and Substance Use
Median wait times for community mental health counselling (in days)	62 days	55 days	March 2026
Integrated youth services availability (number of sites)	0	3	March 2026
Percent of New Brunswickers who report a diagnosed mood or anxiety disorder and needs for mental health care not met	6%	6%Footnote 1	March 2026
Modernizing Health System
Percent of New Brunswickers who have accessed their personal health information electronically at any time	12%	30%	March 2026
Percent of New Brunswick physicians who exchange patient clinical summaries with doctors outside their practice	14%	25%	March 2026

Table IV.2: Selected Indicators from New Brunswick's Provincial Health Plan

Indicator	Baseline	Target	Timeframe
Family Health Services
Percent of non-emergency visits (CTAS Level 5) in urban regional hospitals	9.0%	6.5%	March 2026
Percent of New Brunswickers who have access to their primary care providers within five (5) days	50.8%	55.8%	March 2026
Health Workers and Backlogs
Percent of cataract surgeries completed within NB clinical target timeframe (22 to 180 days)	78%	90%	March 2026
Physician Vacancies	%Footnote 2	-3%	March 2026
Mental Health and Substance Use
Median wait time for One-at-a-Time Therapy (in days)
adult	27.5 days	< 10 days	March 2026
child & youth	23.0 days	< 10 days	March 2026
Percent of mental health clients hospitalized three (3) or more times in a year	14.3%	13.5%	March 2026
Modernizing Health System
Number of New Brunswickers who have access to their MyHealthNB records	62,000	75,000	March 2026
These indicators and targets will appear in the action plan, which will be made available publicly on both federal and provincial/territorial websites. Provinces and territories will also report annually to their own residents on their progress towards these targets.