Safe Restart Agreement Response Letter: Premier of Nunavut

The Right Honourable Justin Trudeau, P.C., M.P.
Prime Minister of Canada
Office of the Prime Minister
80 Wellington Street
Ottawa, ON K1A 0A2

Dear Right Honorable Prime Minister Justin Trudeau,

To protect the health of Canadians, all governments continue to work together effectively to manage the impacts of the global COVID-19 pandemic.

As part of these ongoing collaborative efforts, I am pleased to accept additional federal resources to support critical needs over the next six to eight months through the Safe Restart Agreement. These investments will help to protect public health and safety, prepare for potential future waves of the virus, and further support the safe reopening of economies across Canada.

First Ministers recognize that the Territories face distinct challenges and circumstances, which will need to be addressed separately. First Ministers also recognize that smaller jurisdictions may require funding adjustments beyond per capita allocations.

This letter outlines the Government of Nunavut's funding priorities under the Safe Restart Agreement reached between Canada and the Government of Nunavut to reflect our understandings on shared objectives and the funding commitments made in the seven priority areas. This letter, and its Appendix, represents the entire Safe Restart Agreement and terms reached between our two governments.

The Government of Nunavut's specific allocation and other distribution details for each priority area are also set out and confirmed in the Appendix forming part of this correspondence.

Testing, contact tracing, and data management

The goal of this investment is to help provinces and territories reach a collective capacity to test up to 200,000 people per day across Canada, as well as to improve their contact tracing capacities.

The Government of Canada will provide $4.282 billion to support provinces and territories with the costs of increasing their capacity to conduct testing, perform contact tracing, and share appropriate public health data that will help fight the pandemic. Funding and support will also be provided to provinces and territories to improve and modernize data management across Canada, to help all orders of government coordinate their efforts to contain the virus. Provinces and territories will share relevant information and data.

This federal funding will support the unique testing needs in Nunavut's remote communities. The Government of Nunavut has identified priorities to increase Nunavut's testing capacity and shorten transit time between Nunavut communities and testing labs. This includes renovations to the Rankin Inlet Lab to make space for testing equipment. This also includes the procurement of various testing kits, testing units and testing supplies. The Government of Nunavut commits to sharing disaggregated testing data and procurement.

There will also be a need to increase Nunavut's human resource capacity to support the coordination of specimens, to provide oversight, monitoring and appropriate planning and to provide technical and educational expertise to support Nunavut's response. This will also include access to further technical expertise outside of the territory for greater support.

Due to Nunavut's geography and context, the vast majority of Nunavut's COVID-19 testing in the response so far occurs at partner labs in Alberta, Manitoba, and Ontario. The Government of Nunavut is building capacity in territory with GeneXpert and BioFire systems. Given this and Nunavut's small population relative to the rest of the country, testing goals and capacity needs must be considered in this broader context. Considering Nunavut's context and the challenges that exist for the territory, setting a specific testing target does not add value and can exacerbate existing challenges. It remains difficult to include figures for testing as projections are dependent on several varying factors such as flight patterns between communities, renovations to accommodate the testing machines, and testing capacity at southern labs. At most times, Nunavut does not have the number of symptomatic patients per day to meet daily testing targets.

With respect to contact tracing, funding in this area will support increased staffing and capacity to conduct COVID-19 contact tracing and data management. This includes supports for virtual nursing teams doing follow-up and monitoring as well as the necessary work to keep up with data entry, analysis, and reporting, including links with the territory's electronic health record system.

Health care system capacity

COVID-19 has increased the demands on health care systems across Canada and placed additional strain on mental health. This investment is intended to support the health care services and mental health supports that Canadians rely on, as each jurisdiction addresses the impacts of COVID-19.

The Government of Canada will provide $700 million to support health care systems capacity to respond to a potential future wave of COVID-19. A further $500 million will address immediate needs and gaps in the support and protection of people experiencing challenges related to mental health, substance use, or homelessness. This investment will help to keep Canadians safe and healthy with the health care supports they need.

Considering per capita health expenditures in Canada's north are among the highest in Canada, funding in the area of Health System Capacity will be used to support operational and staffing costs. Due to COVID-19, some medical appointments and procedures are being diverted to the territory's only hospital in Iqaluit from outlying communities. Funds would go towards covering increased costs.

The Government of Nunavut intends to utilize federal funds to support the continued delivery of mental health services and medical and nursing care in its southern isolation hubs. This will ensure Nunavut residents travelling through the isolation hubs and experiencing challenges related to mental health and substance use have access to the necessary supports through in-person, one-on-one mental health supports. In addition to in-person supports, the Government of Nunavut, through a contribution agreement, has provided funding to the Kamatsiaqtut Help Line to increase the organization's capacity to offer COVID- 19 specific supports to Nunavummiut, especially for those in the isolation hubs. The Government of Nunavut plans to also use safe restart funding to support cultural competence training for isolation hub hotel and security personnel. This is to foster an environment that is socially, emotionally, and physically safe for Nunavummiut, and reflective of Inuit values and traditions.

Vulnerable populations

Canadians receiving long-term care, home care, and palliative care are at an increased risk of more severe cases of COVID-19. As the economy restarts, it is important to have continued protections and supports in place for seniors and provide health and social supports to other vulnerable populations.

The Government of Canada will provide $740 million to support costs over the next six to eight months for measures aimed at controlling and preventing infections. This could include addressing staffing issues, in long-term care, home care, and palliative care facilities and services; funding can also be used to support other vulnerable populations.

A significant portion of Nunavut's population is vulnerable due to the lack of efficient access to healthcare resources. This is compounded by Nunavut's remote and isolated communities. The Government of Nunavut continues to prioritize measures to protect all Nunavut residents to control and prevent COVID-19 from entering the territory. This includes the establishment of southern isolation hubs where there is a requirement to quarantine for 14 days prior to travel into Nunavut. The Government of Nunavut has made significant investments of approximately $20M on the southern isolation so far. The Government of Nunavut anticipates that this will continue to be a significant cost driver until better testing capacity is available within the territory. Federal funds will help support ongoing investments of southern isolation hubs.

We may also consider additional supports for correctional facilities to protect staff and inmates.

With respect to the oversight of long-term care Nunavut does not share the same challenges as other provinces and territories. Nunavut's in-territory facilities are either government operated, or they are run with service contracts which the government manages. They have not been significantly affected by COVID 19. Committing to a national standard for supportive care may be difficult at this time, as we anticipate our focus over the next six to eight months to be on the broader public health response and the importance of other interventions.

Municipalities and transit

Municipalities are on the front lines of a safe restart of the economy and need to continue to put in place appropriate precautions to minimize the spread of COVID-19 and manage public spaces and critical services, like public transit.

The Government of Canada will contribute up to $2 billion to support municipalities with COVID-19 operating costs for the next six to eight months. Provincial and territorial governments will continue to support municipalities and will cost-match federal supports with investments flowed this fiscal year for operating costs.

In addition, the Government of Canada will also contribute over $2.3 billion to support any additional contributions by participating provinces or territories for public transit operating costs.

Funds for municipal and transit investments will be cost-shared 50/50. Contributions for municipal supports will recognize provincial and territorial operational investments flowed from April 1, 2020.

The Government of Nunavut has supported municipalities since the beginning of COVID-19. Since April 1, 2020, the Government of Nunavut has provided the following supports to municipalities totaling over $5 million including:

• Hamlet Supports - $2,000,000:
  To help cover expenses incurred as a result of the COVID-19 pandemic, the Government of Nunavut provided municipal governments on April 21st with $2 million. The money went toward materials and supplies, additional janitorial and custodial staff, COVID-19-related signage, information and translation, lost revenue from facility closures, increased bylaw and patrol officers and increased residential water delivery and garbage pickup.
• Beach Monitoring and Day Camps - $550,000:
  This payment to municipalities was to ensure that municipalities have access to additional funding to plan and provide recreational program monitoring. Municipalities needed additional resources to ensure that recreation programming is monitored to ensure COVID measures are being complied with.
  
  Additionally, this funding was used by municipalities to minimize the risk of introducing COVID-19 to Nunavut during the 2020 sealift resupply. Municipalities required resources to ensure that sealift was conducted in the manner outlined in the procedural manual the Government of Nunavut developed.
• Municipal Food Security - $1,050,000:
  The Government of Nunavut provided municipal governments with $1,050,000 in funding to ensure food distribution continued while schools were closed and unable to provide school lunches and breakfasts. It was also used by municipalities to ensure food security for vulnerable populations.
• Airline Standby Services - $1,535,500:
  The Government of Nunavut procured airline standby services between April 1, 2020 and July 19, 2020 on behalf of municipal governments to ensure that air services were available to resupply the Hamlets with essential goods especially fuel.
  
  The Government of Nunavut anticipates providing further supports to municipalities over the next six months to ensure COVID protective measures are complied with and services are maintained. There will be further training required for municipal officials for enforcement of public health orders. Additionally, the reopening of recreational facilities will require additional staff and PPE to ensure programs can be offered in a safely. Finally, there will be a need to offer municipalities financial support to continue to deliver essential services as revenues from user fees will continue to be lower than historical levels.

Personal protective equipment (PPE) for health and non-health workers

COVID-19 has added significant pressure to the procurement and supply of PPE for essential health workers and others. Both orders of government have made significant investments in this area and worked collaboratively to ensure availability of the required equipment at all stage of the pandemic.

To support the restart of the economy, the Government of Canada will commit $4 billion to purchase PPE for national distribution to provinces and territories, $500 million to support the purchase of PPE for the non-health sector, and commit $3 billion directly to provinces and territories for previous and planned PPE investments. To facilitate future procurement, provinces and territories will regularly share relevant PPE-related data with the Government of Canada.

The Government of Nunavut's priority in this area is to maintain an effective and adequate inventory of PPE supplies that reflects the territory's vast geography and limited flight schedule between the three regions. This will support the territory's preparedness in addressing an outbreak, and ensure public (Health, Social Services) and private (grocery stores, gas stations) essential services are safely equipped to handle COVID-19.

Child care for returning workers

The Government of Canada is working with provinces and territories to ensure sufficient child care is available so parents can gradually return to the workplace.

The Government of Canada will provide $625 million to help the sector adapt to the COVID-19 environment and address the reduced availability of child care spaces and the unique needs stemming from the pandemic.

Federal funding will support the Government of Nunavut's work to ensure that Nunavut families have access to safe, effective, and sustained opening of childcare facilities, as well as K-12 schools. The Government of Nunavut priorities include enhanced custodial training for all schools and childcare facilities. Expert environmental consultants will travel on charter flights to train custodians, school leaders and childcare facility staff on safe and best practices for cleaning. In addition, a base level of cleaning supplies and PPE for childcare facilities and schools will be delivered on these charter flights to help prevent the spread to Nunavut families.

The Government of Nunavut's Department of Education has developed opening plans for schools. To ensure that Nunavut students can learn safely from home in the event of an outbreak, The Government of Nunavut will invest in information technology to support remote learning from home. To accomplish this investments will be made to fill Nunavut's gaps to access technology and provide an online learning platform.

Pan-Canadian sick leave

To safely restart the economy, Canada must ensure that workers do not return to work if they have COVID-19 or are showing symptoms.

To encourage workers to remain at home and seek public health advice if they are showing symptoms, the Government of Canada will fund and deliver a new temporary income support program. The estimated $1.1 billion program will support workers who do not already have access to other paid sick leave. The federal government is responsible for all current and future costs of this program.

Where not already available, provinces and territories will seek to establish job protected sick leave so that workers can take advantage of the temporary new federal program.

Government of Nunavut is developing legislation into the Labor Standards Act which would provide protected leave for employees when:

• A government agency has declared an emergency
• A medical or health officer has issued a directive or order telling an employee to stay off work as a result of an emergency
• The employee is required to care for a family member or dependent who is affected by an emergency; or
• Any other exigent circumstance related directly to the declaration of an emergency.

First Ministers believe this funding must quickly be put to use to protect the health and safety of our citizens and to truly help restart the economy. In order to do so, the funding for all priorities will be transferred to the Government of Nunavut through a direct single transfer. This single transfer is in addition to a September transfer for the second tranche of testing funding and is apart from the federal Pan-Canadian Sick Leave program and federal in-kind spending for testing, contact tracing, and data management and PPE.

Each government will continue to publicly report on its actions, to maintain transparency and accountability to the citizens it serves.

Canadians have been well served by the strong, collaborative efforts demonstrated by First Ministers throughout the COVID-19 pandemic. All First Ministers reaffirm their commitment to this approach, while they continue to address their top shared priority, the well-being and safety of all Canadians.

I look forward to the implementation of the Safe Restart Agreement and our continued collaboration.

Sincerely,

Joe Savikataaq
Premier of Nunavut

Appendix - Canada-Nunavut Safe Restart Agreement Investment Details

1. Testing, Contact Tracing, and Data Management
   1. Federal Investment ($M) - $4,282
   2. Allocation Details
      • Per capita allocation;
      • $3,000 cash transfer in two installments;
      • $1,282 in transfers and federal support
   3. Nunavut Allocation ($M) - $3.120
2. Health Care System Capacity
   1. Federal Investment ($M) - $1,200
   2. Allocation Details - Per capita cash transfer
   3. Nunavut Allocation ($M) - $1.248
3. Vulnerable Populations
   1. Federal Investment ($M) - $740
   2. Allocation Details - Per capita cash transfer
   3. Nunavut Allocation ($M) - $0.770
4. Municipalities and Transit
   1. Federal Investment ($M) - $2,000 (municipalities) + $2,300 (transit)
   2. Allocation Details
      • Municipalities - per capita cash transfer, cost shared at 50/50;
      • Transit – cash transfer as applicable, cost shared at 50/50;
      • Provincial and territorial operational investments flowed from April 1, 2020 are recognized
   3. Nunavut Allocation ($M) - $2.080
5. Personal Protective Equipment
   1. Federal Investment ($M) - $7,500
   2. Allocation Details
      • $3,000 per capita cash transfer;
      • $4,550 in federally-delivered support
   3. Nunavut Allocation ($M) - $3.120
6. Child Care for Returning Workers
   1. Federal Investment ($M) - $625
   2. Allocation Details - Base ($2M/jurisdiction) plus per capita cash transfer
   3. Nunavut Allocation ($M) - $2.623
7. Pan-Canadian Sick Leave
   1. Federal Investment ($M) - $1,100
   2. Allocation Details - Federal Delivery