Canada-Ontario bilateral agreement to improve health care services

January 2019

The governments of Canada and Ontario signed a bilateral agreement outlining how the province plans to invest approximately $1.9 billion in targeted federal funding over five years to improve access to home and community care and mental health and addiction services. In 2021-22, this agreement will be renewed for the remaining five years of the ten-year commitment.

Ontario’s Action Plan aligns with the objectives and pan-Canadian priorities set out in the Common Statement of Principles on Shared Health Priorities and will be implemented through a multi-pronged approach.

Home Care and Community Care

Federal funding for home and community care will support Ontario in improving access to home and community care services, including:

• increasing nursing visits and personal care supports for clients with complex needs;
• providing additional supports for palliative and end-of-life care at home or in hospice;
• increasing access to home care services in 125 Indigenous communities across Ontario; and
• strengthening information technology systems, such as expanding the Client Health Record and Information System and other data systems, so that patients and caregivers can be partners in managing their care, and so that communication between clients and caregivers can be improved.

Mental Health and Addiction Services

Federal funding for mental health and addiction services will support innovative, evidence-based approaches to service delivery. Priorities include:

• expanding access to community-based mental health and addiction services for children and youth;
• increasing access to structured psychotherapy and counselling support programs for people with anxiety and depression;
• expanding addiction services for adults, with a focus on addressing the use of opioids, alcohol and cannabis;
• increasing access to early psychosis intervention programs; and
• increasing existing mental health and addiction services and creating new services for priority populations such as racialized, immigrant, refugee, French-speaking and LGBTQ2S populations.

Federal Provincial and Territorial Collaboration to Strengthen Health Care

Budget 2017 committed $11 billion over 10 years in new federal investments to improve access to mental health and addiction services, as well as to home and community care across Canada. Provinces and territories already received the first year of this funding through a legislated transfer following their endorsement of the Common Statement of Principles on Shared Health Priorities*. Funding for the remaining years will flow to provinces and territories through a series of bilateral agreements.

The Common Statement of Principles sets out the objectives and pan-Canadian priorities for federal investments in home care and mental health. It commits governments to addressing specific health system gaps and to focusing efforts in areas that will have the greatest impact. Bilateral agreements will set out the details of how federal funding will be used in alignment with the Common Statement of Principles. As of August 2017, provinces and territories accepted their share of the $11 billion in federal health funding.

Provinces and territories have also committed to working collectively and with the Canadian Institute for Health Information to develop a focused set of common indicators to measure progress and report to Canadians. In June 2018, federal, provincial and territorial health ministers (except Quebec) reached an important milestone in this process by approving a set of indicators for measuring access to mental health and addictions services and to home and community care. CIHI will begin its annual reporting to FPT governments and the public in 2019.

Federal, provincial and territorial governments have also committed to engaging with regional and national Indigenous leaders on their priorities for improving the health outcomes of Indigenous peoples.

*The federal government has agreed to an asymmetrical arrangement with Quebec, distinct from the Common Statement of Principles.