Canada-Yukon 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 -

GOVERNMENT OF YUKON, as represented by the Minister of Health and Social Services (hereinafter referred to as “Yukon” or “Government of Yukon”) as represented by the Minister of Health and Social Services herein referred to as “the Yukon Minister”)

REFERRED to collectively as the “Parties”

PREAMBLE

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

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

  • Improved access of addiction support services by opioid users
  • Reduced substance use post treatment
  • Reduced number of opioid-related deaths
  • Reduced WGH-ED visits resulting from opioid use
  • Reduced WGH admissions resulting from opioid use
  • Reduction in substance use-related harms such as homelessness, violence, and unemployment
  • Reduction in health care costs associated with a reduction in WGH-ED visits, WGH admissions, and HIV and Hepatitis C infections
  • Increased capacity of health care professionals to be involved in the stewardship of opioids to minimize addiction potential, and effective non-opioid pain management

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

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 Yukon through the Canada Health Transfer in order to support health care services within Yukon. 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 Yukon

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 Yukon 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 Yukon, as determined using the 2017 population estimates from Statistics Canada;

L is the number of apparent opioid-related deaths in Yukon 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 Yukon 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 Yukon 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.  Yukon’s 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. Yukon 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. 

Based on the formula described in section 4.2.2, Yukon’s share of the amounts identified in section 4.2.1 will be $500,000.

Yukon’s total contribution will be $445,104, comprised of Yukon’s 1:1 matching contribution (less the $250,000 exception), plus additional funds.

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

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

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

  1. Provides an overview of the opioid crisis and treatment for problematic substance use in Yukon;
  2. Identifies specific priority areas for investment and objectives, which builds upon the progress to date in delivering treatment services;
  3. Highlights those investments Yukon 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 Yukon will use to track progress and report on annually according to their planned investments.

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

  1. Report to the people of Yukon 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 Yukon.
  2. Provide to Canada a 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 Yukon 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 Public Sector Accounting Board standards with attestation from the Department of Health and Social Services’ Director of Finance.

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

5.4 Evaluation

5.4.1 As per established policies and processes with respect to program effectiveness, Yukon 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 Yukon 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 as permitted by law.

7.0 Communications

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

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

Department of Health and Social Services
Government of Yukon
P.O. Box 2703
1 Hospital Road
Whitehorse, YT
Y1A 3H7

Email: Michele.Goshulak@gov.yk.ca

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 Yukon.

13.3 No member of the House of Commons or of the Senate of Canada or of the Legislature of Yukon 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 12th day of December, 2018.

The Honourable Ginette Petitpas Taylor, Minister of Health

SIGNED on behalf of Yukon by the Minister of Health and Social Services at Whitehorse, Yukon this 17th day of December, 2018.

The Honourable Pauline Frost, Minister of Health and Social Services

Annex 1 – Yukon Action Plan

Overview

According to data from the Public Health Agency of Canada, there were seven apparent opioid-related deaths in Yukon in 2016 and seven in 2017. We are aware of three opioid-related deaths in Yukon in 2018. Other deaths that may have been opioid-related are still under investigation.

Data from the Yukon Hospital Corporation shows that Yukon’s emergency departments experienced an increase in drug overdoses from 2016 to 2017 and this trend continues in 2018. Yukon’s hospitals have been seeing an average of 1-2 overdoses per week, with overdoses involving opioids being the most common. From January to May 2018, there were 26 overdose visits and 17 of those overdose visits were opioid-related.

The Yukon government has been actively engaged on the opioid issue since 2016 when fentanyl overdose first became a concern in the territory. Since then, the government has acted swiftly, adapting to new information and changing needs as they have become apparent.

Under the recommendation and leadership of the Chief Medical Officer of Health, the Department of Health and Social Services (HSS) supported the establishment of four working groups focused on harm reduction, public awareness, surveillance, and opioid pain management. We are focusing on both the supply and demand side of opioids, persistently seeking information to provide a fuller picture of what we are seeing in Yukon. We remain vigilant, trying to ensure that changes in prescribing practices do not push desperate people to seek relief from the illicit drug market. Strong partnerships with a variety of government and non-government partners, Yukon First Nations, and the public have shaped and informed Yukon’s Opioid Action Plan, which was released in November 2018.

Opioid Treatment Services (OTS) overview:

Treatment for opioid dependence is provided by the Opioid Treatment Service (OTS) program in Whitehorse. OTS was established to improve the health and wellness of opiate dependent persons by providing an accessible service with the goal of reducing the harms associated with illicit drug use. The current program uses the Methadone Maintenance Program Clinical Practice Guideline from the College of Physicians and Surgeons of British Columbia.

OTS provides medical services with a strong social support component. The social support component may include outreach services such as assisting patients with access to essential services, linking with community resources, and developing rapport with patients to assist in establishing their relationship with the clinic. The Opioid Agonist Program at OTS is a treatment program that involves long-term prescribing of opioid agonists including Suboxone and methadone as safer alternatives to the opioid on which the client was dependent. Central to this program is the provision of counselling, case management and psychosocial services.

Referred Care Clinic (RCC) overview:

The Referred Care Clinic (RCC) in Whitehorse was established in 2011 to support clients by providing comprehensive integrated health services to ‘orphan patients’ with concurrent addictions, pain management and mental health challenges. The needs of this patient group are typically not picked up by family physicians. Accordingly, these patients often have to rely on the Whitehorse General Hospital Emergency Department (WGH-ED) to meet their care needs.

The RCC provides a collaborative model of care through an interdisciplinary team of health practitioners including physicians, nurse practitioners, mental health nurses and outreach workers. The team at the RCC has extensive mental health and addictions knowledge and clinical expertise, and provide patients with medical service with a strong social support component.

In order to better align services, the RCC and OTS were co-located in February 2018. 

Mental Wellness and Substance Use Services (MWSUS) overview:

Mental Wellness and Substance Use Services (MWSUS) provides a wide range of services including counselling, outreach services and community support in all Yukon communities. MWSUS hubs in four communities across Yukon provide a single point of access to a variety of services, including mental wellness support for individuals who have experienced trauma, individual counselling, outreach services, community support and pre- and post-care related to substance use. Intensive Treatment Programs (live-in) in Whitehorse provide addictions treatment and mental wellness support. Withdrawal Management Services in Whitehorse provides a safe and secure environment for individuals going through withdrawal from the effects of substance use or dependence. 

Priority Areas for Investment

Federal funding will be directed towards improving and increasing supports to the OTS program.

Program Evaluation (2016) Recommendations:

A 2016 program evaluation of the RCC and OTS recommended the co-location of both programs. This recommendation was effected in February 2018. Another key recommendation involved enhancing access to complimentary “wrap around” services for RCC and OTS such as social work and psychiatry/mental health services. Given that Yukon’s OTS program focuses on methadone maintenance, the program evaluation found that Yukon’s program would better align with the Methadone Maintenance Program Clinical Practice Guideline from the College of Physicians and Surgeons of British Columbia if access was improved to include social work and mental health supports.

Additional Supports for OTS:

The needs of clients change as their time in treatment lengthens and as they accomplish treatment goals and life changes associated with recovery. One size does not fit all, so in order to support the need for a full continuum of service, a full-time mental health nurse will be added to the team at OTS. The mental health nurse will be responsible for conducting mental health assessments and developing treatment plans; providing mental health counselling or treatments to clients and/or referral and consultation with other human service providers, family members and members of the public; participating in the development of treatment or preventative programs delivered by OTS or in collaboration with other human service agencies; and participating in the training of other human service providers and the overall planning of mental health services in Yukon.

According to the American Society of Addiction Medicine, when methadone maintenance is integrated with a comprehensive treatment service including individual and group psychotherapies and ancillary services such as counselling, it has an efficacy and safety profile that has been solidly and repeatedly established in the clinical outcomes literature since 1965.

Expected Outcomes

It is anticipated that improving and increasing supports to the OTS program will contribute to the following outcomes:

  • Improved access of addiction support services by opioid users
  • Reduced substance use post treatment
  • Reduced number of opioid-related deaths
  • Reduced WGH-ED visits resulting from opioid use
  • Reduced WGH admissions resulting from opioid use
  • Reduction in substance use-related harms such as homelessness, violence, and unemployment
  • Reduction in health care costs associated with a reduction in WGH-ED visits, WGH admissions, and HIV and Hepatitis C infections
  • Increased capacity of health care professionals to be involved in the stewardship of opioids to minimize addiction potential, and effective non-opioid pain management

Monitoring and Evaluation

The implementation of a rigorous evaluation process can assist in determining future program and service adjustments and recommendations for enhancements. The purpose of these measures is to capture information on clinical outcomes, experience of care outcomes, and quality of care outcomes specific to the implementation of increased supports to the OTS program. 

Success can be measured by indicators such as:

  • Number of people receiving treatment for opioid use
  • Number of opioid-related deaths
  • Rate of opioid-related emergency department visits
  • Rate of opioid-related hospital admissions
  • Number of/percentage of primary care practitioners (physicians and nurse practitioners) who prescribe opioid agonist therapy (OAT)

It is difficult to estimate an accurate number of people in Yukon who are in need of opioid treatment. In the Canadian Alcohol and Drug Use Monitoring Survey in 2012, among users of opioid pain relievers, 5.2% (or 243,000 Canadians representing 0.9% of the total population) reported abusing them. This would translate to approximately 322 people in Yukon who abused opioids. It is noteworthy that only 68-78 clients have been served annually by the MMP in Yukon.

Budget and Financial Requirements

The proposed addition of a full-time mental health nurse to the OTS team will involve the following cost:

Table 1. Opioid Treatment Services Mental Health Nurse Cost
Mental Health Nurse 2018-19 2019-20 2020-21 2021-22 2022-23
Salary $95,122 $96,787 $98,480 $100,204 $101,957
Benefits $19,024 $19,357 $19,696 $20,041 $20,391
Salary + Benefits $114,146 $116,144 $118,176 $120,245 $122,349
Totals $28,537Footnote * $116,144 $118,176 $120,245 $122,349

Footnotes

Footnote *

Mental Health Nurse to start in January 2019

Return to footnote * referrer

Table 2. Funding Sources
Funding Sources 2018-19 2019-20 2020-21 2021-22 2022-23

Health Canada Emergency Treatment Fund

$28,537 $116,144 $118,176 $120,245 $116,898
Government of Yukon $0 $0 $0 $0 $5,450
Total $28,537 $116,144 $118,176 $120,245 $122,349

In order to better align services, the RCC and OTS were co-located in February 2018. To provide services that meet the Methadone Maintenance Program Clinical Practice Guideline from the College of Physicians and Surgeons of British Columbia and to allow for fulsome treatment services to be available in Yukon (methadone treatment and Suboxone inductions), physician care specific to the OTS program was increased from one half day per week to three days per week. Additional physician services are shared between OTS and RCC for the remaining two days per week. In addition to the physician services there are shared nurse practitioners, nurses, outreach workers and administrative staff that provide services for both the RCC and OTS.

Table 3. Government of Yukon’s Matching Contribution
Year 2017/18 2018/19
Opioid Treatment Services (OTS) $47,180 $397,924
Amount allocated to Yukon's matching contribution $445,104
Table 4. Performance Measurement
Name of Initiative Expected Results Performance Measurement Expenditure Plan for Emergency Treatment Fund
2018-19 2019-20 2020-21 2021-22 2022-23
Mental Health Nurse for Opioid Treatment Services

Improved access of addiction support services by opioid users

Reduced substance use post treatment

Reduced number of opioid-related deaths

Reduced WGH-ED visits resulting from opioid use

Reduced WGH admissions resulting from opioid use

Reduction in substance use-related harms such as homelessness, violence, and unemployment

Reduction in health care costs associated with a reduction in WGH-ED visits, WGH admissions, and HIV and Hepatitis C infections

Increased capacity of health care professionals to be involved in providing opioid treatment

# of people accessing services at OTS

% of population accessing services at OTS

# of people receiving treatment for opioid use

# of opioid-related deaths

Rate of WGH-ED visits resulting from opioid use

Rate of WGH admissions resulting from opioid use

# of primary care practitioners (doctors and NPs) prescribing OAT

$28,537 $116,144 $118,176 $120,245 $116,898

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