Canada-Northwest Territories Emergency Treatment Fund Bilateral Agreement
BETWEEN:
HER MAJESTY THE QUEEN IN RIGHT OF CANADA (hereinafter referred to as "Canada" or "Government of Canada") as represented by the Minister of Health (herein referred to as "the federal Minister")
- and -
THE GOVERNMENT OF THE NORTHWEST TERRITORIES (hereinafter referred to as "the Northwest Territories" or "Government of the Northwest Territories") as represented by the Minister of Health and Social Services herein referred to as "the Northwest Territories Minister")
REFERRED to collectively as the "Parties"
PREAMBLE
WHEREAS, Canada and the Northwest Territories agree that Canada is in the midst of an opioid crisis that has had a significant effect on many communities, that has claimed the lives of thousands of Canadians from all walks of life, that has had a devastating impact on many Canadian families, and the Emergency Treatment Fund is designed to augment treatment services through one-time funding in response to the opioid crisis;
WHEREAS, Canada and the Northwest Territories agree that immediate action and collaboration is needed among governments to help reduce harms and deaths associated with problematic substance use, including opioids;
WHEREAS, the governments of Canada and the Northwest Territories have committed to work together to further address the opioid crisis, in full respect of their respective jurisdictional responsibilities, and recognizing that the Government of the Northwest Territories has the primary responsibility for the design and delivery of substance use disorder treatment and response services in the Northwest Territories, the one-time Emergency Treatment Fund is intended to augment services and the Northwest Territories will be required to sustain any ongoing initiatives as required;
WHEREAS, Canada has established a transfer payment program called the Emergency Treatment Fund to provide one-time funding to the provincial and territorial governments for the development and delivery of treatment services for problematic substance use, including opioids;
WHEREAS, Canada authorizes the federal Minister to enter into agreements with the provinces and territories, for the purpose of promptly and effectively responding to the opioid crisis and problematic substance use through the Emergency Treatment Fund;
WHEREAS, the laws of the Northwest Territories authorize the Northwest Territories Minister to enter into agreements with the Government of Canada under which the Government of the Northwest Territories undertakes to use the funding provided by Canada under the Emergency Treatment Fund for the provision of treatment services for problematic substance use, including opioids;
AND WHEREAS, the Northwest Territories is responsible for the provision of treatment services including to Indigenous populations accessing treatment services off-reserve.
NOW THEREFORE, Canada and the Northwest Territories agree as follows:
1.0 Purpose
1.1 The Parties are committed to protecting the health and safety of all Canadians through a compassionate and collaborative approach to addressing problematic substance use. The objective is to support single or multi-year projects that will improve access to evidence-based treatment services.
1.2 The purpose of this Agreement is to provide financial support from Canada to the Northwest Territories to target treatment services for problematic substance use, including opioids. This funding will support single or multi-year projects that will build on and enhance existing initiatives, capacity, and priorities.
2.0 Emergency Treatment Services
2.1 Objectives
2.1.1 Canada and the Northwest Territories agree that over the period of this Agreement, with financial support from Canada, the Northwest Territories will address local, regional, and system priorities to reduce opioid-related harms and deaths by further building on and enhancing the Northwest Territories treatment services and programs to improve the availability and accessibility of treatment for problematic substance use towards achieving the objectives of:
- Enhanced coordinated access to OAT across the NWT;
- Enhanced coordinated OAT for transient individuals; and,
- Enhanced practitioner training, skills, and knowledge of opioid use disorder through specialized educational opportunities.
The Northwest Territories' approach to achieving these objectives is set out in its Action Plan attached as Annex 1.
2.2 Eligible Areas of Investment
2.2.1 The Northwest Territories agrees to allocate funds provided by Canada under this Agreement in one or more of the following eligible areas of investment:
- support initiatives that will establish, build on, or enhance existing treatment approaches;
- encourage further implementation of innovative treatment solutions;
- recognize the importance of broader strategies to support access to treatment services by enhancing health care providers' knowledge of best practices.
2.2.2 The types of initiatives for which the Northwest Territories agrees to use the funding may include: enhancements or expansion of existing treatment approaches such as opioid agonist treatments (e.g., methadone, buprenorphine/naloxone), withdrawal management products (e.g., opioid agonist taper and alpha2-adrenergic agonists), oral Naltrexone, psychosocial treatment interventions, and counseling services; innovative treatment solutions such as wrap-around care and injectable agonist therapies; and, implementation strategies to enhance health care providers' knowledge of best practices (alcohol, cannabis, and tobacco are excluded).
2.2.3 Treatment services specifically to address alcohol, cannabis, and tobacco are excluded from this funding.
2.2.4 Types of eligible expenditures may include:
- Operating costs;
- Capital costs;
- Training, professional development and related investments;
- Information technology and related investments; and,
- Other costs that in the opinion of the Parties are essential for the completion of the project and achievement of results.
2.2.5 Canada and the Northwest Territories also agree to promote, define, and deliver identifiable innovative approaches to treatment service delivery.
3.0 Period of Agreement
3.1 This Agreement shall come into effect upon the last signature being affixed and will remain in effect until March 31, 2023, unless terminated in writing by Canada or the Northwest Territories, in accordance with the terms and conditions set out in section 11. Funding provided under this Agreement, in accordance with section 4, will cover the period from April 1, 2018 to March 31, 2023.
3.2 Canada and the Northwest Territories concur that the purpose of this time-limited, one-time Agreement is to help the Northwest Territories more rapidly ramp up or otherwise augment treatment initiatives in light of the opioid crisis, and that ongoing funding for enhanced initiatives established under this Agreement are to be sustained by the Northwest Territories.
4.0 Financial Provisions
4.1 The funding provided under this Agreement is in addition to, and not in lieu of, that which Canada currently provides to the Northwest Territories through the Canada Health Transfer in order to support health care services within the Northwest Territories. Furthermore, this funding is in addition to and not in lieu of those funds that Canada has already provided to address problematic substance use and the opioid crisis.
4.2 Allocation to the Northwest Territories
4.2.1 Canada has designated the following maximum one-time amount of funding to be transferred in total to all provinces and territories under this Agreement: $150,000,000 for the period starting on April 1, 2018 and ending on March 31, 2023.
4.2.2 The final total amount to be paid to the Northwest Territories will be calculated using the following formula:
(F –G x 500,000) x (0.33K/[N-P] + 0.33L/Q + 0.33M/R), where:
- F is the total one-time funding amount available under this initiative;
- G is the number of provinces and territories receiving only the minimum baseline funding (i.e., provinces and territories for which this funding allocation formula results in an allocation of less than $500,000);
- K is the total population of the Northwest Territories, as determined using the 2017 population estimates from Statistics Canada;
- L is the number of apparent opioid-related deaths in the Northwest Territories as determined using 2016 data from the Public Health Agency of Canada's National Report on apparent Opioid-Related Deaths in Canada (based on P/T reporting);
- M is the number of opioid poisoning hospitalizations in the Northwest Territories as determined using 2016-17 data from the Canadian Institute for Health Information's Annual Report on Opioid-Related Harms (based on P/T reporting);
- N is the total population of Canada as determined using the 2017 population estimate from Statistics Canada;
- P is the total population of province and territories receiving only the minimum baseline funding, as determined using the 2017 population estimate from Statistics Canada;
- Q is the total number of apparent opioid-related deaths in Canada, as determined using 2016 data from the Public Health Agency of Canada's National Report on Apparent Opioid-Related Deaths in Canada; and,
- R is the total number of opioid poisoning hospitalizations in Canada as determined using 2016-17 data from the Canadian Institute for Health Information's Annual Report on Opioid-Related Harms (based on P/T reporting).
4.2.3 The Northwest Territories agrees to match Canada's contribution at a 1:1 ratio, with the exception of the first $250,000 in federal funding, for which no cost-sharing is required. The Northwest Territories' matching contribution shall be the equivalent to Canada's contribution less $250,000 and, as outlined in Annex A, can include eligible expenditures made specifically for treatment related to problematic substance use as of January 1, 2016. The Northwest Territories agrees to make reasonable efforts to ensure that previous and ongoing funding from Canada under, pursuant to, or through other programs or agreements shall not be used to match Canada's contribution under this Agreement.
4.2.4 Based on the formula described in section 4.2.2, the Northwest Territories' share of the amounts identified in section 4.2.1 will be:
| Amount to be paid to the Northwest Territories | Amount to be paid by the Northwest Territories |
|---|---|
| $ 500,000 | $ 266,171 |
4.3 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.
4.4 Payment
4.4.1 Canada's contribution under this Agreement as set out in 4.2.4 will be paid within approximately 30 business days of both Parties' signatures being affixed to this Agreement.
4.4.2 The Northwest Territories must spend the entire amount of Canada's contribution by no later than March 31, 2023.
4.4.3 The Northwest Territories must spend the entire amount of the Northwest Territories' matching contribution by no later than March 31, 2023.
4.4.4 Payment of Canada's contribution under this Agreement is subject to an annual appropriation by the Parliament of Canada for this purpose.
4.5 Repayment of Overpayment
4.5.1 Canada and the Northwest Territories agree that every effort will be made to ensure that the calculation of Canada's contribution installment to the Northwest Territories will be accurate.
4.5.2 In the event payment made to the Northwest Territories exceeds the amount to which the Northwest Territories is entitled under this Agreement, the amount of the excess is a debt due to Canada and the Northwest Territories shall repay the amount to Canada within 90 calendar days of written notice from Canada.
4.6 Repayment of Unmatched Funds
4.6.1 In the event that the Northwest Territories does not clearly demonstrate that funds have been cost-matched to the federal funding on a 1:1 ratio less $250,000 by March 21, 2023 in accordance with section 4.2.3, including funding announced as of January 1, 2016, the Northwest Territories agrees to repay the unmatched funds to Canada within 90 calendar days of written notice from Canada.
4.7 Use of Funds
4.7.1 Canada and the Northwest Territories agree that funds provided under this Agreement will only be used by the Northwest Territories in accordance with the areas for investment outlined in section 2.0 of this Agreement and detailed in Annex 1.
5.0 Accountability and Reporting
5.1 Action Plan
5.1.1 The Northwest Territories has completed and shared its Action Plan for the years 2018-19 to 2022-23 of federal funding with Canada, as set out in Annex 1. Upon signature of this Agreement by both Parties, the Northwest Territories will publicly release its Action Plan which:
- Provides an overview of the opioid crisis and treatment for problematic substance use in the Northwest Territories;
- Identifies specific priority areas for investment and objectives, which builds upon the progress to date in delivering treatment services;
- Highlights those investments the Northwest Territories will make in a cost-shared manner equivalent to the federal contribution less $250,000 including initiatives implemented as of January 1, 2016; and,
- Outlines the indicators and specific targets that the Northwest Territories will use to track progress and report on annually according to their planned investments.
5.1.2 The Action Plan may be amended by the Northwest Territories with mutual consent from Canada in a manner consistent with the spirit and intent of this Agreement if deemed necessary by the Northwest Territories to reflect shifts in approach necessitated by changing circumstances or priorities. Such amendments will be done in accordance with section 9.1 and will be made publicly available in accordance with section 7.2.
5.2 Reporting
5.2.1 Within 90 days of both Parties signing this Agreement, the Northwest Territories agrees to:
- Provide all available baseline data on the agreed-to indicators; and
- Describe any initiatives being undertaken in Fiscal Year 2018-2019 as outlined in the Action Plan.
5.2.2 Beginning in Fiscal year 2019-20 and by no later than October 1 of the subsequent Fiscal Year during the Period of this Agreement, the Northwest Territories agrees to:
- Report to the people of the Northwest Territories and to Canada annually on the results and expenditures of the Emergency Treatment Fund allocation until March 31, 2023. The report shall show separately the results attributable to the funding provided by Canada under this Agreement and results attributable to funding provided by the Northwest Territories.
- Provide to Canada a financial statement of revenues received from Canada under this Agreement during the preceding Fiscal Year.
- The revenue section of the statement shall show the amount received from Canada under this Agreement during the Fiscal Year.
- The total amount of funding used for programs and services under section 2.2.
- If applicable, the amount of any amount carried forward by the Northwest Territories under section 4.4.
- If applicable, the amount of any surplus funds that are to be repaid to Canada under sections 4.5 and 4.6.
The financial statement shall be prepared in accordance with Canadian Generally Accepted Accounting Principles with attestation from the Department of Health and Social Services' Chief Financial Officer.
5.2.3 Canada, with prior agreement from the Northwest Territories, may incorporate all or any part or parts of the said report 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.
5.3 Audit
5.3.1 The Northwest Territories will ensure that expenditure information presented in the annual report is, in accordance with The Northwest Territories standard accounting practices, complete and accurate.
5.4 Evaluation
5.4.1 As per established policies and processes with respect to program effectiveness, the Northwest Territories may evaluate programs and services receiving funds provided under this Agreement and make public the results of any such evaluations.
6.0 Long-Term Collaboration
6.1 Canada and the Northwest Territories agree to share and release data as available, and to share knowledge, research and information on effective and innovative practices in treatment programs, to further support the development of and reporting on outcomes.
7.0 Communications
7.1 Canada and the Northwest Territories 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.
7.2 Canada will make publicly available up-to-date Emergency Treatment Fund bilateral agreements entered into with all provinces and territories, including any amendments, on a Government of Canada website.
7.3 Each government will receive the appropriate credit and visibility when investments financed through funds granted under this Agreement are announced to the public.
7.4 Canada reserves the right to conduct public communications, announcements, events, outreach and promotional activities about the bilateral agreements.
7.5 The Northwest Territories agrees to give Canada 10 days advance notice and advance copies of public communications related to this Agreement, and results of the investments of this Agreement.
8.0 Dispute Resolution
8.1 Canada and the Northwest Territories 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 either Canada or the Northwest Territories 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, Canada or the Northwest Territories, as the case may be, may notify the other party in writing of the failure or breach. Upon such notice, Canada and the Northwest Territories will endeavor to resolve the issue in dispute bilaterally through their designated officials at the Assistant Deputy Minister level (hereinafter "Designated Officials").
8.3 If a dispute cannot be resolved by Designated Officials, then the dispute will be referred to the Deputy Ministers of Health for Canada and the Northwest Territories, and if it cannot be resolved by them, then the federal Minister and the Northwest Territories Minister shall endeavor to resolve the dispute.
9.0 Amendments to the Agreement
9.1 This Agreement, including the attached annex, may be amended at any time by mutual consent of the Parties. To be valid, any amendments shall be in writing and signed, in the case of Canada, by the federal Minister, and in the case of the Northwest Territories, by the Northwest Territories Minister.
10.0 Equality of Treatment
10.1 During the term of this Agreement, if another province or territory, except the province of Quebec, negotiates and enters into an Emergency Treatment Fund agreement with Canada, or negotiates and enters into an amendment to such an agreement and if, in the reasonable opinion of the Northwest Territories, any provision of that agreement or amended agreement is more favorable 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 to the Northwest Territories, if requested by the Northwest Territories. This includes any provision of the bilateral agreement except for the Financial Provisions set out under section 4.0. This amendment shall be retroactive to the date on which the Emergency Treatment Fund Agreement or the amendment to such an agreement with the other province or territory, as the case may be, comes into force.
11.0 Termination
11.1 Canada may terminate this Agreement at any time if the terms of this Agreement are not respected by the Northwest Territories by giving at least 12 months written notice of its intention to terminate. The Northwest Territories may terminate this Agreement at any time if the terms of this Agreement are not respected by Canada by giving at least 12 months written notice of its intention to terminate.
11.2 As of the effective date of termination of this Agreement under section 11.1, Canada shall have no obligation to make any further payments to the Northwest Territories after the date of effective termination.
11.3 As of the effective date of termination of this Agreement under section 11.1, the Northwest Territories will repay federal funds on a pro-rated basis after the date of effective termination.
11.4 As of the effective date of termination of this Agreement under section 11.1 the Northwest Territories agrees to return any federal funding not cost-matched by the Northwest Territories consistent with section 4.2.3 and section 4.7.1.
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, postage or other charges prepaid. Any notice that is delivered will have been received in delivery; and, except in periods of postal disruption, any notice mailed will be deemed to have been received eight calendar days after being mailed.
The address for notice or communication to Canada shall be:
70 Colombine Drive
Ottawa, Ontario, K1A 0K9
The address for notice or communication to the Northwest Territories shall be:
Government of the Northwest Territories
P.O. Box 1320
Yellowknife, Northwest Territories
X1A 2L9
13.0 General
13.1 This Agreement, including Annex 1, comprise the entire agreement entered into by the Parties with respect to the subject matter hereof.
13.2 This Agreement shall be interpreted according to the laws of Canada and the Northwest Territories.
13.3 No member of the House of Commons or of the Senate of Canada or of the Legislature of the Northwest Territories 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 deemed to be severable and will be deleted from this Agreement, but all the other provisions of this Agreement will continue to be valid and enforceable.
13.5 The English and French versions of this Agreement, when signed, are equally authoritative.
13.6 This Agreement may be executed in one or more counterparts (including by facsimile or electronic transmission), each of which shall be deemed to be an original instrument, and when all Parties have executed a counterpart thereof, all such counterparts together shall constitute but one and the same Agreement.
SIGNED on behalf of Canada by the Minister of Health at Ottawa, Ontario this 15th day of January, 2019.
The Honourable Ginette Petitpas Taylor, Minister of Health
SIGNED on behalf of the Northwest Territories by the Minister of Health and Social Services at Yellowknife, the Northwest Territories this 22nd day of January, 2019.
The Honourable Glen Abernethy, Minister of Health and Social Services
Annex 1 – Northwest Territories Action Plan
Territorial Context
According to the NWT Bureau of Statistics, the total population of the NWT in 2016 was 44,469, with 22,013 (approximately 50%) identifying as Indigenous. Within these statistics, it must also be noted that each of the thirty-three communities within the NWT has very different realities. The population of Yellowknife in 2016 represented 47% of the entire NWT population, with 20,960 residents. This is in stark comparison to the other regional centres and small communities that comprise the majority of the territory, with the smallest community, Kakisa, having a population of less than 50 people.
The Northwest Territories has a vibrant First Nations, Metis and Inuit population that make up over 50% of the population. In November of 2017, Alberta Health released a report titled "Opioids and Substances of Misuse among First Nations People in Alberta." Some of the key points of this report included the three times higher rate of death from accidental opioid overdose among First Nations people in comparison to non-First Nations. It also identified that the rates of overdose deaths among First Nations People were less likely to be connected to illicit fentanyl than non-First Nations.
Opioid Crisis in the NWT
In February 2015, a rise in the use of street fentanyl prompted the Chief Public Health Officer to issue a public health advisory regarding the dangers associated with the drug. Illicit fentanyl had been appearing in green pill and powder form and sold as other substances. In November 2016, a second public health advisory was issued following several near fatal overdoses in just a 24 hour period. The public was advised to be on high alert of the presence of illicit drugs in Yellowknife and to also expect that they may have made their way to other NWT communities.
Response and Treatment
Opioid Maintenance Therapy Program (OMTP)
The Yellowknife Health and Social Service Authority created the Opioid Maintenance Therapy Program (OMTP) in 2015 after the territorial influx of Illicit Fentanyl into the territory. The OMTP was designed to help meet the needs of individuals struggling with Opioid Use Disorder. It is run out of the Yellowknife Primary Care Centre and is available for people who are using street based opioids such as fentanyl, morphine, oxycodone, codeine or who are struggling to control their use of prescribed opioids. Individuals who use this service are provided options for treatment such as opioid replacement medications (methadone, Suboxone), counselling and/or facility based out-of-territory treatment programs. The OMTP has primarily served Yellowknife-based individuals living with Opioid Use Disorder and provides out-of-Yellowknife care on a case-by-case basis.
Prior to the implementation of the OMTP in 2015, one physician had been providing Opioid Replacement Therapy (ORT) in Yellowknife only. Following its implementation, the program grew to include partial hours of a Community Mental Health Nurse and a counsellor and eventually evolved to include four physicians.
The OMTP has minimal access to Yellowknife-based case management services, which is a crucial component of ORT. Individuals who are located outside of Yellowknife are required to access subsidized medical travel to either drive or fly to Yellowknife to then access services through the primary care centers. To date, the Northwest Territories Health and Social Services Authority (NTHSSA) has not been able to secure case management resources for the OMTP program, resulting in physicians carrying a substantial portion of the case management workload for individuals located in and out of Yellowknife.
The NWT correctional system was identified as an area of need and as such, the OMTP has been working with the North Slave Correctional Complex (NSCC) in Yellowknife. The NSCC is the largest and most secure of the three correctional facilities located in the NWT. The OMTP has been working with the NSCC medical team to create improved pathways to ensure that individuals who are incarcerated receive continuity of opioid agonist treatment (OAT) care between the NSCC and the OMTP. The OMTP has prioritized seeing individuals before their release to allow for ongoing OAT as they transition back into community. Many of these individuals come from outside of Yellowknife and the ability to coordinate this care is often hampered by lack of accessible case management.
NWT Opioid Misuse and Overdose Task Group
In December 2016, the Minister of Health and Social Services with the Government of the Northwest Territories (GNWT) established the NWT Opioid Misuse and Overdose Task Group. The Task Group is led by the Public Chief Health Officer and includes members from GNWT Departments and representation from the NTHSSA, the Royal Canadian Mounted Police (RCMP), and the public. The mandate of the Task Group is to respond to ongoing issues related to opioid drug misuse and overdoses and provides strategic oversight, leadership and coordination. This Task Force has coordinated projects such as:
- Take Home Injection Naloxone Kits – NWT Naloxone Kit Distribution took place in all regions of the NWT. Information about Opioid abuse and naloxone availability was also distributed.
- Public Awareness Campaign to inform residents of the Northwest Territories about the risks associated with illicit opioid use.
- Improving surveillance with regard to opioid morbidity and mortality
- Prescription Monitoring Program
- Territorial ORT Enhancement – with a focus on territory-wide access
Priority Areas for Investment through the Emergency Treatment Fund
The need for enhanced access to OAT services has and will likely continue to increase, along with the number of NWT residents accessing OAT across the territory. Faced with limited operational resources and funding opportunities, additional human, educational and clinical resources are required in order to enhance access to critical and lifesaving OAT services across the NWT.
The Government of Canada's contribution of $500,000 through the Emergency Treatment Fund, will be directed towards the Opioid Enhancement Project from FY 2018-19 to 2022-23. This initiative will provide at risk NWT residents access to an effective, efficient, integrated and culturally safe OMTP.
Objectives include:
- Enhance coordinated access to OAT across the NWT
- Enhance coordinated OAT for transient individuals
- Enhance practitioner training, skills, knowledge of opioid use disorder through specialized educational opportunities
- Territorial assessment of gaps and strengths in communities and regional centres outside of Yellowknife
The following position and service subsidization will be established through federal funding to support this initiative:
- Territorial OMTP Lead and Case Manager: Full time position reporting to the NTHSSA Territorial Manager of Mental Health and Addictions Services
- OMTP Individual Support:
- Advocating and pathfinding for individuals who require housing, financial and legal assistance and other services; and,
- Appointment management, coordinating with medical travel, arranging telehealth appointments and other.
- OMTP Regional and Territorial Program Development and Support:
- Attending and coordinating interdisciplinary weekly rounds, program development meetings
- Update and provide oversight for OMTP structure, e.g. intake and contract forms are available and appropriate for different settings (NSCC, community based)
- Coordinate Corrections OMTP Transition - development and implementation of transition pathways from incarceration to community-based care
- Environmental Scan of Regional Centres, treatment services, and some small communities:
- Health Centre audits to clarify number of patients with OUD, red flags for prescription opioid use, known illicit opioid use
- Community resource assessment – clarify/identify gaps and treatment resources in each community (e.g. community pharmacy capacity when present, health centre capacity, NGO addiction services when present, etc.).
- OMTP Individual Support:
- Opioid Replacement Therapy Skills Enhancement:
- Enhance Physician capacity territorially for Opioid Agonist Treatment
- Provide funding to nursing staff and physicians living in the NWT but outside of Yellowknife to train and receive point of care support to become OAT providers
- Establish OAT Physician Champions within the health system to ongoing training to locum physicians and sustain enhanced OMTP access long-term
- Enhance Registered Nurse (RN) /Licensed Practical Nurse (LPN) capacity for safe Territorial OAT program delivery
- Provide funding to RNs and LPNs living in the NWT but outside of Yellowknife to seek further education independently or through Yellowknife based OMTP providers
- Establish ORT RN/LPN Champions within the health system to provide ongoing training to locum staff and to sustain enhanced OMTP access long-term
- Enhance Physician capacity territorially for Opioid Agonist Treatment
- The GNWT will supplement Health Canada's contribution to this initiative though the work of an established position in the NTHSSA providing support to addiction services, This 0.3 FTE will equate to $266,000 over the next four years. The Associate Territorial Clinical Lead (aTCL) of Addictions position will specifically support this initiative as follows:
- The aTCL assists and advises the Territorial Medical Director in the areas of planning, operating and evaluating delivery of health care services within her assigned Clinical Domain which is Addictions, throughout the Northwest Territories Health and Social Services Authority (NTHSSA).
- The Clinical Domain of Addictions includes all practitioners who work in these clinical domains throughout the territory. Practitioners are defined as physicians, nurse practitioners, dentists and midwives. Although the aTCL is not directly responsible for managing practitioners, she will be providing the primary clinical support to the Territorial OMTP Lead and Case Manager through a dyad relationship with the NTHSSA Territorial Manager of Mental Health and Addictions Services.
- Liaising with her colleagues at the DHSS, Hay River Health and Social Services Authority (HRHSSA) and the Tlicho Community Services Agency (TCSA), the aTCL of Addictions will ensure consistency of OAT policies and procedures across the NWT
- When feasible, the aTCL of Addictions will assist and advise the development and implementation of the OMTP service delivery throughout the territory in the Clinical Domain of Addictions that are characterized by a patient-centered, culturally competent, appropriate, safe and collaborative practice between practitioners and other members of the health care team.
- She will also provide leadership in the creation and maintenance of OMTP policies and procedures that promote territory-wide clinical standards.
| Description | Expected Results | Performance Measurement |
|---|---|---|
The Opioid Enhancement Project will aim to provide at risk residents of the NWT access to an effective, efficient, integrated and culturally safe OMTP. While, the OMTP is an already existing approach in the NWT, the project will enhance current services and increase access beyond Yellowknife. The Opioid Enhancement Project will start September 2018 and end September 2023. |
|
|
Expenditure Plan
| Funding Source | Initiative | Budget Items | 2019-20 | 2020-21 | 2021-22 | 2022-23 | Total |
|---|---|---|---|---|---|---|---|
| Federal Emergency Treatment Fund | Opioid Enhancement Project | Territorial OMTP Lead Case Manager | |||||
| Compensation and Benefits | 131,000 | 131,000 | 131,000 | 72,050 | 465,050 | ||
| One-Time Position O and M | 3,000 | - | - | - | 3,000 | ||
| Ongoing Position O and M | 9,000 | 9,000 | 9,000 | 4,950 | 31,950 | ||
| Total Health Canada Opioid Enhancement Funds | 143,000 | 140,000 | 140,000 | 72,050 | 500,000 | ||
| Territorial Cost-Matching | Associate Territorial Clinical Lead (aTCL) of Addictions | Compensation and Benefits | 66,543 | 66,543 | 66,543 | 66,543 | 266,171 |
| Total NTHSSA Contribution | 66,543 | 66,543 | 66,453 | 66,543 | 266,171 | ||
| Total | 209,543 | 206,543 | 206,543 | 143,543 | $766,171 | ||
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