Supporting Pathways to Care for People Who Use Drugs

Invitation to Submit a Letter of Intent (LOI)

The Public Health Agency of Canada (PHAC) is pleased to invite eligible organizations to submit applications for funding for projects that catalyze system-level change to enhance pathways to care for people who use drugs.

Applicants can request project funding for a maximum of 15 months, totalling between $350,000 and $1,000,000. All project funding will end March 31, 2021.

This is an anticipatory solicitation process. Final funding decisions will be subject to available funds.

How to Apply:

The full application process for this solicitation consists of two stages. The first stage is the submission of a Letter of Intent (LOI) Form, with a cover letter and required appendices. The second stage involves PHAC inviting applicants whose LOIs are successful to submit a full proposal.

The application package for the first stage must be submitted before 11:59pm ET, August 30, 2019, to: phac.cgc.solicitations-csc.aspc@canada.ca with the subject line LOI Pathways to Care. No extensions will be granted. Applications will be acknowledged by email. Please ensure that your email address is included in your application.

Applications must be submitted using PHAC’s Pathways to Care LOI Form. To obtain a copy of the Form and Applicant Guide, contact: phac.cgc.solicitations-csc.aspc@canada.ca with the subject line LOI Pathways to Care. Please note that the previous deadline of 11:59pm ET, August 7, 2019, to request an application package has been extended. You may request an application package until 11:59pm ET, August 30, 2019.

Investment Overview and Objectives

Overview

Canada is facing the largest public health crisis in recent memory. Over 11,500 people in Canada have lost their lives as a result of opioid-related overdoses between January 2016 and December 2018. Individuals who use other substances, such as methamphetamines, or engage in polysubstance use, are also experiencing harms, including fatal and non-fatal overdose.

While the Government of Canada has implemented a wide range of actions to address the opioid crisis, significant gaps exist in our ability to comprehensively understand and mobilize interventions that work, particularly in relation to pathways to care that meet people where they are at, from prevention to harm reduction to treatment, and health care more broadly.

Health systems are at the front line of support for people using drugs; yet we know from people with lived and living experience, researchers, and health professionals that extensive barriers continue to block access to these pathways and needed care, particularly for those individuals who are members of multiple marginalized communities. At a structural level, systems are often not set up to best serve those most impacted by health and social inequities; and stigma, discrimination and a lack of understanding of the root causes of substance use can create barriers to accessing and receiving appropriate care.

Emerging evidence suggests that in some regions of the country, nearly half of people who died as a result of the opioid crisis came into contact with health systems in the period preceding their death.^{Footnote 1Footnote 2} These interactions represent potential missed opportunities to save lives.

Objectives of this Funding Opportunity

The objective of this new funding opportunity is to support projects that catalyze system-level change with enduring impact to enhance pathways to care and reduce barriers for people who use drugs.

Projects funded through this investment should support sustainable system-level change that includes:

• Foundational policies or practice guidelines that embrace proven and promising intervention models that can support pathways to care and reduce barriers for people who use drugs;
• Capacity development to increase the skills and knowledge of the workforce to implement the policies or practice guidelines; and
• Practical tools and resources to support ongoing implementation.

Many proven and promising intervention models already exist that are helping to support effective pathways to care for people who use drugs and other marginalized groups and that are ready for scale-up, expansion or adaptation. Funded projects should leverage and mobilize existing evidence-based interventions, such as:

• Peer support and system navigation that support people who use drugs to access available health systems.
• Equity-oriented approaches, which aim to improve how systems are designed, organizations function and practitioners engage with people, to respond to the unique and diverse needs of individuals.
• Contact-based programing, which can help to reduce stigma and misconceptions about substance use and people who use drugs.

Project activities can include the development and implementation of:

• Policies, practice guidelines/procedures;
• Training materials and curriculum; and
• Other practical tools and resources to support implementation.

Important Note: Projects funded through this investment cannot be used for the provision of services that are the responsibility of other governments or federal departments (e.g., health care delivery, purchase of medical devices, services on-reserve or within correctional facilities, etc.)

Required Collaboration

Applicants must demonstrate that the project team (applicant and collaborators) has the capacity and access to implement system-level change that will have an enduring impact across the targeted system.

Applicants are required to collaborate with at least one other organization or entity that can support the proposed system-level change. Applicants may also choose to collaborate with other organizations or individuals across sectors or disciplines to achieve project objectives. Where applicable, applicants should leverage existing networks and partnerships.

Investment Principles

The following principles must clearly inform the content of all LOIs for this funding opportunity.

Health Equity

Health equity is fostered by the absence of unfair/unjust, systematic and avoidable differences in health status or social determinants of health between population groups. It includes consideration of sex and gender and other factors such as age, education, language, geography, culture and income. PHAC promotes a health equity approach that increases access to opportunities and conditions conducive to health for all.

Evidence-based

Evidence refers to rigorous, scientific research and/or evaluation of the intervention, or the application of relevant research and/or strong theoretical underpinnings to support the relevance and impact of the proposed intervention and/or adaptation of the intervention to a new context or audience.

Engagement

Engagement refers to meaningful involvement of the intended audience to inform and improve the design of the approach or resources. This should include engagement with people with lived and living experience, as appropriate.

Non-stigmatizing

Stigma leads to discrimination, which prevents people from getting the services and supports they need. Non-stigmatizing initiatives model a person-centred approach, promote stigma-free language and messaging and actively support the reduction of fear, stigma, misinformation and misunderstanding.

Cultural Safety

Promoting and improving cultural safety involves working across ethnic and other diverse factors to help systems and organizations ensure that service environments are safe for all, regardless of culture. Cultural safety is particularly important for Indigenous peoples but is relevant across cultures.

Trauma- and Violence Informed

Trauma- and violence-informed practice is a client-centred model that is built on knowledge about the impact of violence and trauma on people’s lives and health. This knowledge should be incorporated into all aspects of policy, practice and programming in ways that foster clients’ safety, respect and empowerment.

Who Can Apply

Only applicants in following categories may be considered for funding:

• Canadian not-for-profit voluntary organizations and corporations;
• for profit organizations^{Footnote *};
• provincial, territorial, regional and municipal governments and agencies;
• organizations and institutions supported by provincial and territorial governments (regional health authorities, post-secondary institutions);
• unincorporated groups, societies and coalitions; and
• Indigenous organizations.

Evaluation Criteria

The following criteria will be used to evaluate all applications for funding. The specific assessment criteria that will be applied in stage 1 are outlined on the LOI Form.

• the project’s goals and objectives are clear, realistic and achievable, and aligned with the objectives of the funding program;
• the applicant has identified appropriate collaborator(s) that can support the proposed system-level change;
• the project is aligned with the investment principles;
• the project is innovative and sustainable;
• the project’s key activities are clearly described and aligned with the project goals and objectives;
• the system in which the project will be implemented is clearly identified and appropriate;
• the project’s potential reach is significant but achievable;
• the project’s expected results are realistic and measurable;
• the project demonstrates efficient use of resources and value for money;
• the application clearly demonstrates how this project is informed by and leverages existing evidence in this field;
• the application clearly demonstrates the need for and the value-add of the project; and
• the applicant and/or their collaborator(s) have demonstrated the required expertise, capacity, resources and governance structure to successfully deliver the proposed project.

Funding Decisions

PHAC is under no obligation to enter into a funding agreement as a result of this invitation to submit a LOI. A successful LOI is not a commitment on the part of PHAC to fund a subsequent full proposal.

This is a two-stage process. Only applications successful at the LOI stage may be invited to submit a full proposal in stage two.

Funding decisions will be based on a review of proposals and subject to available funds. Not all applications will be funded. With available resources, PHAC anticipates supporting 5 to 7 projects through this time-limited investment.

PHAC is responsible for determining the eligibility of each applicant, its project and project-related expenses.

PHAC also reservces the right to:

• reject any submission received in response to this invitation;
• accept any submission in whole or in part; and
• cancel and/or re-issue this invitation to submit a LOI at any time.

All applicants will be notified by email of the results following the end of the review process.

Decisions related to funding for applicants made by PHAC are final.

Please note that PHAC will not reimburse an applicant for costs incurred in the preparation and/or submission of a LOI or a full proposal in response to this invitation.

Roles and Responsibilities

Responsibilities of Successful Applicants

Funding Agreement

If the proposed initiative is approved, your organization will:

• enter into a legally binding funding agreement with the Public Health Agency of Canada and be legally accountable to the Public Health Agency of Canada for prudent expenditure of the funds; and
• ensure that the initiative is efficiently carried out and achieves the initiative objectives in accordance with the funding agreement.

Responsibilities of Public Health Agency of Canada

PHAC will:

• ensure that program representatives will be available to provide assistance, advice, and support as you implement your initiative.

Contact Us

To obtain a copy of the application documents and additional information about this solicitation, please contact: phac.cgc.solicitations-csc.aspc@canada.ca with the subject line LOI Pathways to Care.