Canada-Prince Edward Island 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 -

HER MAJESTY THE QUEEN IN RIGHT OF PRINCE EDWARD ISLAND (hereinafter referred to as “Prince Edward Island” or “Government of Prince Edward Island”) as represented by the Minister of Health herein referred to as “the Prince Edward Island Minister”)

REFERRED to collectively as the “Parties”

PREAMBLE

WHEREAS, Canada and Prince Edward Island 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 Prince Edward Island 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 Prince Edward Island 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 Prince Edward Island has the primary responsibility for the design and delivery of substance use disorder treatment and response services in Prince Edward Island, the one-time Emergency Treatment Fund is intended to augment services and Prince Edward Island 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, Executive Council  authorizes the Minister of Health and Wellness to enter into agreements with the Government of Canada under which the Government of Prince Edward Island 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, Prince Edward Island is responsible for the provision of treatment services including to Indigenous populations accessing treatment services off-reserve.

NOW THEREFORE, Canada and Prince Edward Island 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 Prince Edward Island 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 Prince Edward Island agree that over the period of this Agreement, with financial support from Canada, Prince Edward Island will address local, regional, and system priorities to reduce opioid-related harms and deaths by further building on and enhancing Prince Edward Island treatment services and programs to improve the availability and accessibility of treatment for problematic substance use towards achieving the objectives of:

  1. Reduce physical and financial barriers to accessing opioid replacement therapy;
  2. Optimize opioid replacement therapy initiation and delivery;
  3. Enhance supports for current opioid replacement therapy clinics and patients; and
  4. Increase client support networks.

Prince Edward Island’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 Prince Edward Island 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 Prince Edward Island 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 Prince Edward Island 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 Prince Edward Island, 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 Prince Edward Island concur that the purpose of this time-limited, one-time Agreement is to help Prince Edward Island 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 Prince Edward Island.

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 Prince Edward Island through the Canada Health Transfer in order to support health care services within Prince Edward Island. 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 Prince Edward Island

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 Prince Edward Island 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 Prince Edward Island, as determined using the 2017 population estimates from Statistics Canada;

L is the number of apparent opioid-related deaths in Prince Edward Island 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 [province/territory] 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 Prince Edward Island 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.  Prince Edward Island matching contribution shall be the equivalent to Canada’s contribution less $250,000 and, as outlined in Annex 1, can include eligible expenditures made specifically for treatment related to problematic substance use as of January 1, 2016.  Prince Edward Island 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, Prince Edward Island’s share of the amounts identified in section 4.2.1 will be:

Table 1: Prince Edward Island’s Share of Amounts Identified in section 4.2.1
Amount to be paid to Prince Edward Island (in 2018/19) Amount to be paid by Prince Edward Island
$518,506 $566,000

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 Prince Edward Island must spend the entire amount of Canada’s contribution by no later than March 31, 2023.

4.4.3 Prince Edward Island must spend the entire amount of Prince Edward Island 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 Prince Edward Island agree that every effort will be made to ensure that the calculation of Canada’s contribution installment to Prince Edward Island will be accurate.

4.5.2 In the event payment made to Prince Edward Island exceed the amount to which Prince Edward Island is entitled under this Agreement, the amount of the excess is a debt due to Canada and Prince Edward Island 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 Prince Edward Island 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, Prince Edward Island 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 Prince Edward Island agree that funds provided under this Agreement will only be used by Prince Edward Island 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 Prince Edward Island 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, Prince Edward Island will publicly release its Action Plan which:

  1. Provides an overview of the opioid crisis and treatment for problematic substance use in Prince Edward Island;
  2. Identifies specific priority areas for investment and objectives, which builds upon the progress to date in delivering treatment services;
  3. Highlights those investments Prince Edward Island will make in a cost-shared manner equivalent to the federal contribution less $250,000 including initiatives implemented as of January 1, 2016;
  4. Outlines the indicators and specific targets that [province/territory] will use to track progress and report on annually according to their planned investments.

5.1.2 The Action Plan may be amended by Prince Edward Island with mutual consent from Canada in a manner consistent with the spirit and intent of this Agreement if deemed necessary by Prince Edward Island 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, Prince Edward Island agrees to:

  1. Provide all available baseline data on the agreed-to indicators; and
  2. 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, Prince Edward Island agrees to: 

  1. Report to the people of Prince Edward Island 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 Prince Edward Island.
  2. Provide to Canada an audited financial statement of revenues received from Canada under this Agreement during the preceding Fiscal Year
    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 programs and services under section 2.2.
    3. If applicable, the amount of any amount carried forward by [province/territory] under section 4.4.
    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 and the audit shall be performed by the Prince Edward Island Auditor General or his/her delegate, or by an independent public accounting firm registered under the laws of Prince Edward Island and shall be conducted in accordance with Canadian Generally Accepted Auditing Standards.

5.2.3 Canada, with prior agreement from Prince Edward Island, 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 Prince Edward Island will ensure that expenditure information presented in the annual report is, in accordance with Prince Edward Island standard accounting practices, complete and accurate.

5.4 Evaluation

5.4.1 As per established policies and processes with respect to program effectiveness, Prince Edward Island 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 Prince Edward Island 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 Prince Edward Island 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 agreement. Canada agrees to give Prince Edward Island 10 days advance notice and advance copies of public communications related to this Agreement, and results of the investments of this Agreement.

7.5 Prince Edward Island 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 Prince Edward Island 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 Prince Edward Island 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 Prince Edward Island, as the case may be, may notify the other party in writing of the failure or breach. Upon such notice, Canada and Prince Edward Island 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 Prince Edward Island, and if it cannot be resolved by them, then the federal Minister and Prince Edward Island 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 Prince Edward Island, by the Prince Edward Island 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 Prince Edward Island, 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 Prince Edward Island, if requested by Prince Edward Island.  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 Prince Edward Island by giving at least 12 months written notice of its intention to terminate. Prince Edward Island 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 Prince Edward Island after the date of effective termination. 

11.3 As of the effective date of termination of this Agreement under section 11.1, Prince Edward Island 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 Prince Edward Island agrees to return any federal funding not cost-matched by Prince Edward Island 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 Prince Edward Island shall be:

Minister of Health and Wellness
95-105 Rochford Street
Charlottetown, Prince Edward Island, C1A 7N8

copied to
Health PEI
Att: Chief Administrative Officer, Mental Health and Addictions
Hillsborough Hospital,115 Deacon Grove Ln,
Charlottetown, PE C1C 1M3

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 Prince Edward Island.

13.3 No member of the House of Commons or of the Senate of Canada or of the Legislature of Prince Edward Island 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 This Agreement is drafted in English at the request of the Parties. Les parties ont convenu que le présent Accord soit rédigé en anglais.

SIGNED on behalf of Canada by the Minister of Health at Ottawa, Ontario this 12th day of February, 2019.

The Honourable Ginette Petitpas Taylor, Minister of Health

SIGNED on behalf of Prince Edward Island by the Minister of Health and Wellness at Charlottetown, Prince Edward Island this 15th day of February, 2019.

The Honourable Robert Mitchell, Minister of Health and Wellness

Annex 1 – Emergency Treatment Fund – Prince Edward Island Action Plan

Overview of the Opioid Crisis in PEI

In 2017, the Government of PEI established a “PEI Action Plan to Prevent and Mitigate Opioid Overdoses and Deaths”. The Action Plan was developed in response to the increasing numbers of opioid-related overdoses and deaths occurring in other Canadian jurisdictions, and the anticipated arrival of fentanyl and other highly toxic opioids into the illegal market in PEI.  The presence of illegal fentanyl in PEI was confirmed in pills seized by the RCMP for the first time in the province in June 2017.

The presence of fentanyl and other potent synthetic opioid products, as well as in other illegal drugs, has been linked to increases in opioid-related and deaths in Canada.  In 2016, there were five incidental (unintentional) opioid-related deaths in PEIFootnote 1.  All deaths involved mixed toxicology (i.e. one or more opioids, plus one or more non-opioid substances).

The development of the “PEI Action Plan to Prevent and Mitigate Opioid Overdoses and Deaths” builds on existing efforts that PEI has made in addressing opioid misuse and opioid use disorder over the last decade.  Through professional and effective collaboration across government and with the community, PEI has successfully implemented several initiatives including:

  • Establishing the Drug Information System, which captures opioid prescribing and dispensing data and flags duplicate therapy, when clients fill more than one active opioid prescription;
  • Establishing methadone maintenance clinics, including sites in Charlottetown, Summerside, and Montague to provide the recommended first-line treatment for opioid use disorder;
  • Establishing a Needle Exchange Program, with seven sites across PEI, to support harm reduction; and
  • Passing the Narcotics Safety Awareness Act in 2013, to enable the establishment of a formal prescription monitoring program.
  • Improved treatment options for Opioid Replacement Therapy (ORT) in April of 2017 by increasing access/removing barriers to buprenorphine/naloxone (Suboxone).

The purpose of the 2017 PEI Action Plan to Prevent and Mitigate Opioid Overdoses and Deaths is to prevent and mitigate unintentional opioid overdoses and deaths among youth and adults in Prince Edward Island.

The scope of the action plan includes the following areas of focus:

  • Surveillance of opioid-related overdoses and death;
  • Rapid Response protocol to address a sudden increase in opioid-related overdoses in PEI;
  • Harm reduction, including access to naloxone, communications and education, and opioid replacement therapy;
  • Appropriate prescribing and dispensing of prescription opioids; and
  • Diversion of prescription opioids.

These areas of focus were identified as immediate priorities with the ultimate goal of preventing and mitigating the rate of opioid overdose and death in the population. PEI publicly reports on progress related to the action plan biannually. The most recent report was published in October 2018.

In the 2019-2020 capital budget, the PEI government announced investment of $100 million over five years for Mental Health and Addictions to include a new campus style hospital with four community access centres in Charlottetown, Summerside, West Prince and Kings County. It is anticipated that these community hubs would be open 12 hours a day, seven days a week, where people can have access to services and community mental health and addictions staff. The aim is to support clients as close to home as possible.

Priority Areas for Investment

Opioid Replacement Therapy (ORT) is available in PEI to clients with opioid dependence to enable them to discontinue opioid use without experiencing withdrawal symptoms. Trained physicians provide ORT by prescribing methadone or buprenorphine/naloxone (Suboxone) accompanied by counseling and connecting individuals to other health and social supports.

There are gaps, however, in access to ORT services resulting in treatment retention issues and preventing some individuals from initiating treatment altogether. These gaps are related to cost, rural geography, very limited public transportation outside of the Charlottetown area, scheduling issues, treatment engagement and access (isolation of the Island), stigma, and client-centered (including families) approach to treatment.

Consistent with the current PEI Action Plan to Prevent and Mitigate Opioid Overdoses and Deaths, the Government of Canada’s contribution of $518,506 from the Emergency Treatment Fund will be aimed at reducing gaps in access to services and will build on existing treatment capacities. The initiatives described below will require a full time project manager for six months to develop an implementation plan which will include an evaluation component in order to establish baseline data, engage in Continuous Quality Improvement (CQI) and report on outcomes during the period of this agreement.

Objectives

  • Reduce physical and financial barriers to accessing opioid replacement therapy;
  • Optimize opioid replacement therapy initiation and delivery;
  • Enhance supports for current opioid replacement therapy clinics and patients; and
  • Increase client support networks.

Initiatives

A. Telehealth/telemedicine, digital treatment modalities:

Telehealth services are a proven use of technology to augment traditional treatment to connect clients in remote and rural settings with various clinical experts in more centralized locations.

Telehealth is already in use in PEI for some programs and services and can be used in the treatment of opioid use disorder. It is proposed that traditional face to face access will be augmented through the use of an encrypted, secure video connection to physicians with expertise in addictions who are located in central locations (e.g., Charlottetown and Summerside). This service delivery model will be used especially in underserved areas of PEI. 

This initiative will also support community outreach by community addictions nurses, which is a practice already in place in community mental health. It is anticipated that nurses will partner with community health centers to meet clients or travel to client’s home if required while having the technology available (a vehicle equipped with the appropriate technology) to securely access the physician located centrally (e.g., Charlottetown) to provide real-time consultation, mobile interviewing, assessment, counselling and treatment initiation or support. Clients could also have access to digital group treatment/therapy.

This augments treatment options/services and enables clients without transportation, including public transit, to access necessary treatments in a timely and efficient manner.
Funding will be allocated to hardware, software and equipment to increase treatment access, facilitate remote treatment services, and/or promote wrap-around care in the treatment of opioid dependence across PEI. The funding allotment will be for fiscal year 2019-2020 to develop and pilot a mobile service delivery option to enhance access to treatment services closer to client communities (e.g., a satellite site to meet clients for interviewing, counseling, group work, urine screens). This includes the development of digital capacity to enable mobile interviewing. Two .5 FTE RNs as well as funds related to medications, diagnostics and other direct costs of care will be required to manage the overall anticipated increase of clients across PEI.

It is planned that three to four mobile sites will have the infrastructure in place in 2019-2020 and fully operational in year 2020 and onwards.
Expected outcomes: Increased clients served; increased access to treatment and improved retention in treatment programs; reduced doctor’s office and emergency room visits and hospital admissions; reduced medical complications (including overdoses and deaths) and overall health care costs.

B. The establishment of a peer support training and development program. 

Peer support workers as members of clinical teams bring a unique, non-traditional perspective that provides people with addiction with a sense of hope and practical help as they move toward recovery. Treatment teams benefit from the presence of a peer support worker on the team as it helps the team see things from the client's perspective. Peer support workers serve as educators, advocates, bridges to community resources and partners in facilitating recovery. They build on the client's strengths, resources and shared experiences to reshape the client's story from one of illness to one of recovery and ability.

Peers play a unique and non-traditional role, which may vary according to the patient's particular needs. They deal with clients individually and also lead group sessions on various topics. As part of the care team, they represent the client to the team and vice versa.

This program will consist of persons with lived and living experience receiving training to support existing and new clients receiving treatment for problematic opioid-related substance use. The anticipate result for this model will augment treatment and support for clients by providing a more holistic and client-centered approach to treatment.

Integrating peer support workers into clinical teams will require preparation and training for all members of the team as well as the peer support worker. Program development will include the following:

  • Development of policies, procedures, remuneration plan;
  • Communication and collaboration with all traditional team members;
  • Peer recruitment, screening and selection;
  • Training of peers and health care professionals;
  • Change management framework;
  • Evaluation, adjustment and scale-up.

Expected Outcomes: increased admissions/ inductions into ORT; Increased client retention in programs; Increased client satisfaction with client centered care; Decreased rates of relapse; Increased health care provider satisfaction.

Below is a table illustrating the amounts that the Province of Prince Edward Island has invested in enhancement initiatives within the above mentioned priority areas which align with Health Canada’s Emergency treatment and bilateral agreement.

Table 2: Performance Measurement and Expenditure Plan
# Name of Initiative Expected Outcome/Results Performance Measurement Expenditure Plan
2019/20 2020/21 TOTAL

A

Establishment of a videoconference / Telehealth IT infrastructure and staffing

Increased clients served; increased access to treatment and improved retention in treatment programs; reduced physician office and emergency room visits and hospital admissions; reduced medical complications.

  • Average/Median wait times for treatment after referral;
  • % of population accessing treatment;
  • # of people accessing treatment by region;
  • # of physician, ER and hospital visits;
  • Average and median LOS on Program;

$200,000

$250,506

$450,506

B

The establishment of a peer support training and development model 

  • Increased client retention in programs;
  • Increased client satisfaction with client centered care;
  • Decreased rates of recidivism;
  • Increased health care provider satisfaction.
  • # of peer supporters in place
  • # of people trained
  • # of training opportunities
  • Median LOS on Program;
  • Recidivism rate;
  • # of people leaving the service;
  • Increased client satisfaction

$10,000

$15,000

$25,000

In addition: 1.0 FTE Project Manager for six months is $43,000

  • Initiative A: $450,506
  • Initiative B: $25,000
  • Project Manager: $43,000
  • Total: $518,506

Cost-sharing by the Government of PEI

Beginning April 1, 2016, the Government of PEI enhanced the Opioid Replacement Therapy (ORT) program in the Province, through the enhanced access to suboxone. The total expenditures related to this enhanced access amount to approximately $566,000 since April 1, 2016:

Table 3: Cost-sharing by the Government of PEI
Description 2016/2017 2017/2018 2018/2019 (Estimated) Total, 2016/2017 – 2018/2019
Enhanced Access to Suboxone $86,000 $230,000 $250,000 $566,000
Footnote 1

Opioid-Related Death: An acute intoxication/toxicity death resulting from the direct effects of the administration of substance(s) where one or more of the substances is an opioid.

Return to footnote 1 referrer

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