Canada-Nunavut 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 NUNAVUT (hereinafter referred to as “Nunavut”) as represented by the Minister of Health herein referred to as “the Nunavut Minister”)
REFERRED to collectively as the “Parties”
PREAMBLE
WHEREAS, Canada and Nunavut 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 Nunavut 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 Nunavut have committed to work together to further address the opioid crisis, in full respect of their respective jurisdictional responsibilities, and recognizing that the one-time Emergency Treatment Fund is intended to augment services and that Nunavut will be required to sustain the ongoing initiatives established using the Emergency Treatment Fund (services under pillar #1 of Annex 1 of this Agreement);
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 Nunavut Act authorizes the Nunavut Minister to enter into agreements with the Government of Canada under which the Government of Nunavut 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 Government of Nunavut has existing and ongoing collaborative and financial relationships with Government of Canada departments/agencies, including with Indigenous Services Canada, for the provision of health care services, and nothing in this Agreement shall be prejudicial to these existing and ongoing collaborative and financial relationships.
NOW THEREFORE, Canada and Nunavut 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 Nunavut 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 Nunavut agree that over the period of this Agreement, with financial support from Canada, Nunavut will address local, regional, and system priorities to reduce opioid-related harms and deaths by further building on and enhancing Nunavut treatment services and programs to improve the availability and accessibility of treatment for problematic substance use towards achieving the objectives of:
- Increasing the availability of land-based programs to treat problematic substance use;
- Increasing capacity for such services to be delivered beyond the capital and in several Nunavut communities; and
- Mitigating the use of substances to cope with unresolved trauma as a way to prepare individuals and communities for the opioid crisis should it become more prevalent in Nunavut.
Nunavut’s 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 Nunavut 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 Nunavut 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.
2.2.3 Treatment services specifically to address alcohol, cannabis, and tobacco only 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 Nunavut 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 Nunavut, 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 Nunavut concur that the purpose of this time-limited, one-time Agreement is to help Nunavut more rapidly ramp up or otherwise augment the treatment initiatives under pillar #1 referenced in Annex 1 in light of the opioid crisis, and that ongoing funding for enhanced initiatives established under pillar #1 referenced in Annex 1 of this Agreement is to be sustained by Nunavut.
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 Nunavut through the Canada Health Transfer in order to support health care services within Nunavut. 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 Nunavut
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 Nunavut 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 Nunavut, as determined using the 2017 population estimates from Statistics Canada;
- L is the number of apparent opioid-related deaths in Nunavut 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 Nunavut 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 Nunavut 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. Nunavut’s 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. Nunavut 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, Nunavut’s share of the amounts identified in section 4.2.1 will be:
| Fiscal Year | Amount to be paid to Nunavut | Amount to be paid by Nunavut |
|---|---|---|
| 2018-2019 | $500,000 | $250,000 |
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 Nunavut must spend the entire amount of Canada’s contribution by no later than March 31, 2023.
4.4.3 Nunavut must spend the entire amount of Nunavut’s 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 Nunavut agree that every effort will be made to ensure that the calculation of Canada’s contribution installment to Nunavut will be accurate.
4.5.2 In the event payment made to Nunavut exceeds the amount to which Nunavut is entitled under this Agreement, the amount of the excess is a debt due to Canada and Nunavut 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 Nunavut 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, Nunavut 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 Nunavut agree that funds provided under this Agreement will only be used by Nunavut 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 Nunavut has completed and shared its Action Plan for the years 2018-19 to 2022-23 of federal funding under this Agreement with Canada, as set out in Annex 1. After signature of this Agreement by both Parties and Nunavut having made the document titled “Summary Report – Addictions and Trauma Treatment in Nunavut” public, Nunavut will publicly release its Action Plan which:
- Provides an overview of the opioid crisis and treatment for problematic substance use in Nunavut;
- Identifies specific priority areas for investment and objectives, which builds upon the progress to date in delivering treatment services;
- Highlights those investments Nunavut 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 Nunavut will use to track progress and report on annually according to their planned investments.
Nunavut will publicly release its Action Plan within 60 business days after signature of this Agreement by both Parties and after the document titled “Summary Report – Addictions and Trauma Treatment in Nunavut” is made public. Nunavut will keep Canada informed of advancements and the anticipated date that the Summary Report will be made public.
5.1.2 The Action Plan may be amended by Nunavut with mutual consent from Canada in a manner consistent with the spirit and intent of this Agreement if deemed necessary by Nunavut 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, Nunavut 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, Nunavut agrees to:
- Report to the people of Nunavut and to Canada annually on the results and expenditures of the Emergency Treatment Fund allocation until March 31, 2023. The report shall show the results attributable to the funding provided by Canada under this Agreement and results attributable to funding provided by Nunavut using the following elements of information listed in Annex 1: the indicators listed under the column titled “Performance Measurement” under the “Federal ETF Investment” table and the points under the “financial reporting header”.
- 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 Nunavut 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’s Chief Financial Officer.
5.2.3 Canada, with prior agreement from Nunavut, 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 Nunavut will ensure that expenditure information presented in the annual report is, in accordance with Nunavut standard accounting practices, complete and accurate.
5.4 Evaluation
5.4.1 As per established policies and processes with respect to program effectiveness, Nunavut 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 Nunavut 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 Nunavut 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. Nunavut’s Agreement and Action Plan will not be published by Canada until Nunavut has made the document titled “Summary Report – Addictions and Trauma Treatment in Nunavut” public.
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 Once Nunavut has made the document titled “Summary Report – Addictions and Trauma Treatment in Nunavut” public, Canada reserves the right to conduct public communications, announcements, events, outreach and promotional activities about this Agreement.
7.5 Nunavut 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.
7.6 Canada agrees to give Nunavut 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 Nunavut 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 Nunavut 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 Nunavut, as the case may be, may notify the other party in writing of the failure or breach. Upon such notice, Canada and Nunavut will endeavor to resolve the issue in dispute bilaterally through their designated officials at the Assistant Deputy Minister level for Canada and the Associate Deputy Minister for Nunavut (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 Nunavut, and if it cannot be resolved by them, then the federal Minister and Nunavut 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 Nunavut, by the Nunavut 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 Nunavut, 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 Nunavut, if requested by Nunavut. 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 Nunavut by giving at least 12 months written notice of its intention to terminate. Nunavut 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 Nunavut after the date of effective termination.
11.3 As of the effective date of termination of this Agreement under section 11.1, Nunavut 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 Nunavut agrees to return any federal funding not cost-matched by Nunavut 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:
Health Canada
70 Colombine Drive
Brooke Claxton Building
Ottawa, Ontario, K1A 0K9
The address for notice or communication to Nunavut shall be:
Deputy Minister of Health
Department of Health, Government of Nunavut
PO Box 1000, STN 1000
Iqaluit, Nunavut, X0A 0H0
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 Nunavut.
13.3 No member of the House of Commons or of the Senate of Canada or of the Legislature of Nunavut 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.
SIGNED on behalf of Canada by the Minister of Health at Ottawa, Ontario this 7th day of December, 2018.
The Honourable Ginette Petitpas Taylor, Minister of Health
SIGNED on behalf of Nunavut by the Minister of Health at Ottawa, Ontario this 7th day of December, 2018.
The Honourable George Hickes, Minister of Health
Annex 1 – Problematic Substance Use in Nunavut Action Plan
Context
The impact of Nunavut’s remoteness on the delivery of treatment programs and services is such that the cost of establishing, operating and maintaining these programs are staggeringly high and prohibitive. The high cost of operating these programs, coupled with a population spread across a very large territory, places a considerable obstacle to the provision of these programs.
In Nunavut, problematic substance use and the prevalence of unresolved trauma are largely intertwined as explained in a needs assessment and feasibility study for addictions and trauma treatment completed in summer 2018:
Addictions and trauma are inextricably linked with the historical and intergenerational trauma experienced by Inuit across Inuit Nunangat and within the present day territory of Nunavut. Historical and intergenerational trauma is deeply rooted, stemming from permanent settlement in communities (with ongoing poor housing conditions), forced relocations, ‘mission-ization’ (encounters and associated influences of western religion), dog slaughter, residential schools, tuberculosis sanatoria, forced acculturation and associated loss of language, culture, traditions, social and family structures, loss of ability to fully live on and depend on the land and traditional foods/resources, disintegration of family structure and self-esteem associated with clearly defined roles for men, women and children, and imposition of new systems of government.
The experience of historical trauma has precipitated societal responses that have themselves become embedded across generations, leading to intergenerational and cyclically rooted social and health conditions among Nunavummiut, including problematic substance use […].
Substances of choice
In Nunavut, alcohol and cannabis are the primary substances used although other substances are available and in use, if to a lesser extent.
- Binge drinking has been identified as a significant issue in Nunavut by:
- The Qikiqtani Truth Commission, which indicated that “rates of heavy drinking in Nunavut are four times those in the rest of Canada”.
- The Nunavut Liquor Act Review task Force, which identified increasing alcohol consumption – especially among youth –and rates of binge drinking well above the Canadian average.
- The 2015-2016 Community Health Survey found that over half of respondents who had consumed alcohol in the past twelve months had also engaged in binge drinking.
- The Canadian Community Health Survey also found that:
- 27% of respondents reported consuming marijuana or hashish once or more a week over the past twelve months, and about one in 10 (11%) reported using every day.
The 2013-2014 Canadian Community Health Survey covered substance use frequency for the Inuit sample and found that:
- Over 95% of respondents report having never used cocaine/crack in their lifetime.
- Over 99% of respondents report having never used speed (amphetamines) in their lifetime.
- Over 97% of respondents report having never used ecstasy (MDMA) in their lifetime.
- Almost 100% of respondents report never having used heroin in their lifetime.
- 98% of respondents reported having never used hallucinogens, PCP, or LSD in their lifetime.
State of the opioid crisis
At the time of writing, Nunavut has yet to experience the opioid crisis in the dire fashion experienced by several other Canadian jurisdictions. This state of affairs could change in the future. By improving access to treatment for problematic substance use and trauma now, it will help prepare individuals and communities for the opioid crisis should it become more prevalent in Nunavut.
Treating Problematic Substance Use to Avoid Escalation to Harder Substances
As previously noted, unresolved trauma and problematic substance are interlinked in Nunavut. Unresolved trauma and the distress associated with it are factors that encourage several Nunavummiut to use of substances as a coping mechanism. For many, this coping mechanism results in severe negative effects.
The Emergency Treatment Fund investments will be used to set up on-the-land treatment for problematic substance use and trauma as described under pillar #1 below. This program is outlined in greater detail below and will help people struggling with unresolved trauma and problematic substance use heal, develop healthy coping mechanisms, and build skills to reduce or avoid self-medication using substances. Participation in such programs will help prevent client’s use from escalating to harder substances, like opioids obtained through medical channels or contraband should illegal circulation increase in Nunavut.
Priority area for investment
The feasibility study proposed a three-pillared approach to addressing addictions and trauma in Nunavut. These are:
- Pillar #1: Enhanced community based systems offering On-the-Land (OTL) healing camps and other in-community supports.
- Pillar #2: A residential treatment facility in Iqaluit, which in this report is referred to as the Nunavut Recovery Centre (NRC).
- Pillar #3: Development of an Inuit workforce that can staff both OTL healing camps as well as the Nunavut Recovery Centre.
Emergency Treatment Funding will be channeled to cover part of the start-up costs for the services to be put in place under pillar #1.
Description
Pillar #1 leverages existing strengths within Nunavut, such as experience and capacity at the community level when it comes to offering trauma recovery support and on-the-land programming.
The Cambridge Bay Wellness Centre has run the Connections Treatment Program, which consists of 28-day, on-the-land treatment cycles. The feasibility proposes to provide stable funding for this program to run more frequently, to open it to residents of other Kitikmeot communities and to replicate in the other regions of Nunavut. Through the feasibility study, the Cambridge Bay Wellness Centre has agreed to let other organizations use and deliver the Connections Treatment Program.
The Nunavut Department of Health would enter into agreement(s) with organizations to deliver the programming. Each organization would offer a problematic substance use and trauma treatment program in an on-the-land camp set up close to its home community and accept participants from all communities within their region. Cycles would welcome 8 participants each and may alternate between client groups (e.g. men, women, youth, families, etc.). The other-in community supports referred to in the title for pillar #1 refer to the fact that each operator would receive funding to maintain additional year-round staff to plan for the deliveries, support intake, participate in the delivery of the program and contribute to aftercare.
Expected results
The table below shows the results expected by pillar #1 being implemented and operationalized.
| Region | Cycle type | Cycles/year | Clients/year |
|---|---|---|---|
| Kitikmeot | On-the-land | 4 | 32 |
| In community | 2 | 16 | |
| Kivalliq | On-the-land | 3 | 24 |
| Baffin | On-the-land | 3 | 24 |
| Total | 12 | 96 |
Expenditure plan
Costs related to Pillar #1 fall in two categories:
- Capital and start-up investments
- Operational costs (ongoing investments)
The feasibility study estimated the costs involved as follows:
| Annual operating costs | ||||||
|---|---|---|---|---|---|---|
| Region | Start-up costs | 2019/20 | 2020/21 | 2021/22 | 2022/23 | 2023/24 and ongoing |
| Qiqiktaaluk | $297,481 | $1,033,647 | $1,033,647 | $1,033,647 | $1,033,647 | $1,033,647 |
| Kivalliq | $306,856 | $1,052,045 | $1,052,045 | $1,052,045 | $1,052,045 | $1,052,045 |
| Kitikmeot | $162,943 | $1,508,931 | $1,508,931 | $1,508,931 | $1,508,931 | $1,508,931 |
| Total | $767,280 | $3,594,623 | $3,594,623 | $3,594,623 | $3,594,623 | $3,594,623 |
Use of funds
The Government of Nunavut will apply the $500,000 from Health Canada’s Emergency Treatment Fund investments towards the estimated total expenditure of $767,280 in capital and start-up costs for pillar #1. These funds will cover addictions training and miscellaneous capital equipment, including minor capital and consumables specifically required to carry out activities that are part of the On-the-Land program that is culturally relevant and accessible in the Nunavut context.
It is anticipated that these funds will be spent by the end of fiscal year 2019/20, with the possibility of extending into 2020/21 if necessary. These funds may be transferred to the camp operators through contribution agreements, service contracts or a combination thereof.
As per the agreement to secure the $500,000 in Emergency Treatment Funding from Health Canada, the Government of Nunavut needs to demonstrate expenditures of at least $250,000 on treatment between 1 January 2016 and 31 March 2023. It is expected that Nunavut’s share ($250,000) will be spent on operating costs in year 2019-2020. If necessary, Nunavut may push back part of or all of its contribution to 2020-2021.
The funding may be allocated across regions in different proportions than what is shown in the table above.
Planned federal and territorial expenditures, expected results, and performance measurement indicators are identified as follows:
| Initiative | Expected results | Performance measurement | 2018-19 | 2019-20 |
|---|---|---|---|---|
Enhanced community based systems offering On-the-Land (OTL) healing camps and other in-community supports. |
|
|
$500,000 | $0 |
| Sub-total | $500,000 | $0 | ||
Total
$500,000
|
||||
| Initiative | 2018-19 | 2019-20 |
|---|---|---|
| Enhanced community based systems offering On-the-Land (OTL) healing camps and other in-community supports. | $0 | $250,000 |
| Total territorial expenditures: | $250,000 | |
Financial reporting
Starting in fiscal year 2018/19 and until the end of fiscal year 2022/23, the Government of Nunavut will report to Health Canada yearly on the following:
- Portion of the $500,000 in Emergency Treatment Funding transferred to operators in each Nunavut region during the fiscal year; and
- Portion of the Government of Nunavut’s required contribution (total of $250,000) under the agreement spent during the fiscal year.
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