Backgrounder: CanadaNewfoundland and Labrador bilateral agreement to improve health care services


January 2018

Today, the governments of Canada and Newfoundland and Labrador signed a bilateral agreement outlining how the province plans to invest $72 million in targeted federal funding over five years to improve access to home and community care and mental health and addiction services. In 2021-22, this agreement will be renewed for the remaining five years of the ten-year commitment.

Newfoundland and Labrador’s Action Plan aligns with the objectives and pan-Canadian priorities set out in the Common Statement of Principles on Shared Health Priorities.

Home Care and Community Care
Newfoundland and Labrador has been developing and implementing a Home First Initiative which will see transformational change in how services are delivered to individuals with complex care needs, including palliative and end of life care, who want to receive their care at home. The province’s investments will:

  • Develop a Home First Integrated Network and implement a Home First approach in the province, to provide wrap around services to clients, maximize regional health authority resources and extend available services in the community beyond traditional work hours.
    • Increasing clinical services in regional health authorities, including additional clinicians to deliver complex care.
  • Invest in palliative care and end-of-life improvements in the province. This will include:
    • Enhancing clinical positions for palliative and end-of-life care;
    • Implementing training for clinicians, service providers and caregivers involved in the provision of palliative and end-of-life;
    • Promoting palliative care and advanced health care planning; and
    • Supporting the creation and operation of hospice beds in two regional health authorities.
  • Expand supports for persons with dementia, including:
    • Providing better respite for caregivers;
    • Implementing training for providers and caregivers; and
    • Expanding remote monitoring technology to support patients and their caregivers.

Mental Health and Addictions
In addition to sustained provincial investments, federal funding will be used to advance and expand initiatives under the Towards Recovery Mental Health and Addictions Action Plan. These initiatives include:

  • Implementing a provincially-integrated mental health service delivery model for children, youth and young adults to address existing barriers and gaps in current services;
  • Expanding existing and introducing new e-mental health initiatives to support a continuum of e-health for all ages and ensuring evidence-based models of community mental health care and culturally-appropriate interventions are integrated with primary health care;
  • Improving access to addictions services in the province to address opioid issues; and
  • Improving community-based services to replace hospital care, including access to peer support, psychological therapies, flexible assertive community treatment (FACT) teams and evidence-based intensive case management teams.

Federal Provincial and Territorial Collaboration to Strengthen Health Care

Budget 2017 committed $11 billion over 10 years in new federal investments to improve access to mental health and addiction services, as well as to home and community care across Canada. Provinces* and territories already received the first year of this funding through a legislated transfer following their endorsement of the Common Statement of Principles on Shared Health Priorities. Funding for the remaining years will flow to provinces and territories through a series of bilateral agreements.

The Common Statement of Principles sets out the objectives and pan-Canadian priorities for federal investments in home care and mental health. It commits governments to addressing specific health system gaps and to focusing efforts in areas that will have the greatest impact. Bilateral agreements will set out details of how federal funding will be used in alignment with the Common Statement of Principles. As of August 2017, provinces and territories accepted their share of the $11 billion in federal health funding.  

Provinces and territories have also committed to working collectively and with the Canadian Institute for Health Information to develop a focused set of common indicators to measure progress and report to Canadians. 

Federal, provincial and territorial governments have also committed to engaging with regional and national Indigenous leaders on their priorities for improving the health outcomes of Indigenous peoples.

* The federal government has agreed to an asymmetrical arrangement with Quebec, distinct from the Common Statement of Principles 

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