Letter of agreement to amend bilateral agreements for home and community care and mental health and addiction services

March 30, 2022

The Honourable Jean-Yves Duclos
Minister Of Health
House Of Commons
Ottawa, ON K1A 0A6

Dear Minister Duclos,

The COVID-19 pandemic has created significant challenges for Canadians and has especially affected those residing in long-term care homes. Outbreaks in long-term care homes have taken the lives of some of Canada’s vulnerable risk citizens, impacting their families and caregivers. To address this unanticipated global crisis, Ontario has taken swift and evolving action to optimize the safety of long-term care residents, their caregivers and families, and the staff who care for them every day. Since Spring 2020, Ontario has allocated over $2.5 billion towards a broad range of measures for enhanced infection prevention and control, some of which has been supported by federal investments and resources.

The Government of Canada committed on November 30, 2020 to augment support for provinces and territories through a new Safe Long-term Care Fund. The Safe Long-term Care Fund provides jurisdictions an additional $1 billion with the aim of further protecting Canadians who reside in these settings through increased infection prevention and control measures. As such, Canada and Ontario agree, through this Letter of Agreement, to amend the Canada-Ontario Home and Community Care and Mental Health and Addictions Services Agreement (the Bilateral Agreement) in accordance with appendices A and B to this Letter.

The amendments in Appendix A establish the terms and conditions that apply to the Safe Long-term Care funding and include the following:

• The Government of Canada will provide Ontario with total funding of up to $379,575,486 under the Safe Long-term Care Fund for eligible expenditures incurred from December 1, 2020 to March 31, 2022.
• The federal funding through the Safe Long-term Care Fund will support Ontario’s comprehensive efforts to enhance infection prevention and control in long-term care homes. Funding can be used towards retention measures for existing staff, including wage top-ups, and/or hiring of additional human resources; new infrastructure and renovations to existing infrastructure, such as ventilation, or self-isolation or single rooms; readiness assessments to prevent COVID-19 infections and spread; and measures aimed at preventing or mitigating the entry and spread of COVID-19 (e.g., surveillance testing).
• Ontario has attached an amended action plan (Appendix B) which includes: background on long-term care in Ontario; efforts undertaken since spring 2020 to mitigate the impact of COVID-19 in long-term care homes; information on the initiatives that will be supported by the Safe Long-term Care Fund, including with regards to expenditures; and, measures to track progress.
• Ontario will utilize cost-recovery agreements with all homes that benefit from the funding under the Safe Long-term Care Fund to ensure that federal investments are used to enhance the protection of residents and staff and to ensure transparency in the use of funds. Ontario will amend its action plan to provide information with respect to homes benefiting from the federal investments, including confirming that cost-recovery agreements through existing reporting and reconciliation processes are in place and the estimated amount to be recovered. In addition, Ontario will provide information on how it will invest funds recovered through the cost-recovery agreements in infection prevention and control, in keeping with this program.
• Ontario will amend its performance measurement section of the action plan and will further update this section to provide information on long-term care results, with a view to showcasing the significant progress achieved to protect highest risk Ontarians living in long-term care homes through its initiatives and investments for increased infection prevention and control.

Appendix B to this Letter of Agreement sets out Ontario’s amendment to its action plan (Annex 2 to the Agreement) which provides information on the initiatives, expenditures, expected results and performance metrics on the initiatives supported by the Safe Long- term Care funding.

Except as set out in the appendices to this Letter of Agreement, the terms of the Bilateral Agreement will remain in effect.

This Letter of Agreement to amend the Bilateral Agreement will be effective upon both of our respective signatures. It, along with the updated Agreement and annexes, will be made public online by Health Canada.

The Honourable Paul Calandra,
Ontario Minister of Long-Term Care

March 30, 2022

The Honourable Jean-Yves Duclos
Federal Minister of Health

March 31, 2022

c: Hon. Christine Elliott, Minister of Health and Deputy Premier