Fact Sheet - Extension of the Territorial Health System Sustainability Initiative - October 2010

News Release: Minister Aglukkaq Announces Two Year Extension of Territorial Health System Sustainability Initiativ

October 2010

In 2005, the Government of Canada provided the territories with a five-year $150 million targeted fund, the Territorial Health System Sustainability Initiative (THSSI), to facilitate the transformation of territorial health systems toward greater responsiveness to Northerners' needs and improved community-level access to services.

Budget 2010 extended THSSI funding by $60M over two years, to consolidate the progress made in the first five years of the Initiative and allow the territories adequate time to conclude or re-profile activities funded under the previous five year fund.

Funds are administered through funding agreements with the territorial governments and subdivided into three components:

1. A Medical Travel Fund to:
   • Offset or help pay for expenses related to or incurred in the course of providing or paying for medical transportation.
2. A Territorial Health Access Fund to:
   • Reduce reliance over time on the health care system;
   • Strengthen community level services; and,
   • Build self-reliant capacity to provide services in-territory
3. An Operational Secretariat Fund to:
   • Fund several Pan-Territorial projects;
   • Provide Territorial governments with capacity resources to manage THSSI commitments; and,
   • Support the functioning of a Federal/Territorial Assistant Deputy Ministers' Working Group to guide the implementation of the initiative.

Frequently Asked Questions 

Q1 - What is the total of $60 million over two years being used for among the three territories?

• The funding is being shared among the three territories over two years to support territorial health system transformation; off-set medical travel costs; support medical travel system reforms to contain the costs associated with medical travel; and support pan-territorial projects.

Q2 - How is the total of $60 million being allocated?

• The $60 million is shared among the three territories over two years. The Territorial Health Access Fund amounts are divided equally between the three territories and the Medical Travel Fund amount is allocated on the basis of medical travel requirements with Nunavut receiving the greatest amount due to the remoteness of its communities. Specifically:
  • $30 million is directed to offsetting direct medical travel costs; $20.4 million for Nunavut, $6.4 million for Northwest Territories, and $3.2 million for Yukon. This funding can be used to offset actual medical travel expenses or used for projects to directly reduce medical travel costs;
  • $26 million is allocated equally among the three territories ($8.6 million per territory) to support three broad goals: to reduce reliance over time on the health care system; strengthen community level services; and build self-reliant capacity to provide services in-territory; and,
  • $4 million is shared between the three territories to support pan-territorial projects and fund the Federal/Territorial Assistant Deputy Minsters' Working Group, which oversees the THSSI.

Q3- What has the initiative accomplished so far?

• THSSI provided the territorial governments with the opportunity to explore innovative solutions to service delivery gaps resulting in changes to their respective health care delivery systems. Additionally, it supported a range of prevention and promotion activities, allowed the territories to address some clinical services issues, and served as a catalyst for territories to identify and consider evolving needs and develop responsive strategies.

Highlights of key territorial initiatives implemented under the first five years:

• Yukon:
  • Development and implementation of a Health Human Resources Strategy which focused on recruitment and retention of health professionals throughout the territory.  One aspect was the mentorship program which matched experienced nurses with newer staff to improve skills and boast confidence. 
  • Design and set-up of the Yukon's HealthLine which allows people to access quality health information from any phone at any time of day or night.  This reduces the impact on front line staff particularly in small communities.
  • Support for Yukoners who are dying through palliative care in their own communities--Whitehorse and rural areas.  This program helps families, working with professionals and volunteers provide for their loved ones as they die.
  • Implementation of the Smoke-Free Places Act which reduces smoking near buildings and in cars and homes when kids are present.
  • Help for people in the Yukon with chronic conditions like diabetes and COPD.  This has been a successful collaborative effort between physicians and nurses in physician's offices which has improved the health of patients.
• Northwest Territories:
  • Expansion of nursing resources in smaller communities through the creation of two Community Health Nurse positions in communities that previously had only one nurse, increased training for Community Health Nurses, addition of new Nurse Practitioners in communities. Implementation of programs that increased access to health services such as expanded midwifery and dialysis programs, additional respite care, a health program for pregnant women, and enhanced home and community care.
  • Implementation of several disease prevention and health promotion activities including anti-smoking and mental health campaigns aimed at children and youth, development of a strategy to prevent Fetal Alcohol Spectrum Disorder (FASD), programs to prevent sexually transmitted infections and colorectal cancer, supported living services for older adults and adults with disabilities, and training and development of Primary Community Care teams that deal with mental health and addictions clients.
  • Enhancement of the recruitment, staffing, and retention of physicians through return of service bursaries and purchase of NWT medical school and specialist resident seats, a resident support program which provided support and funding for residents' accommodation and travel costs, and implementation of a new physician-staffing model.  
  • Implementation of the Foundation for Change plan for reform of the delivery of health and social service programs throughout the NWT.
• Nunavut
  • Implementation of the Public Health Strategy including projects such as Healthy Foods North, Tobacco prevention and community partnerships.
  • Development of comprehensive report on the state of health care in Nunavut and identification of health care needs.
  • Increased physician and specialist services in the communities.
  • Building northern capacity by training programs such as Mental Health, Maternity Care and Midwifery, Community Therapy and Home and Continuing care.
  • Improving the management of medical travel to help curb expenditures  in the long term
  • Development and implementation of initiatives that contribute to a long-term health human resources plan.
• Pan-territorial
  • Mass media collaboration to help territories campaign for good health practices and share mass media packages for issues such as sexual health, elder abuse and FASD 
  • Oral health initiative to improve the oral health status of children 0-10 years of age.
  • Orientation project to design a comprehensive orientation program for health care professionals.

Q4- How does Health Canada know that the first five years of THSSI have been successful?

• An independent third-party evaluator conducted a Summative Evaluation at the conclusion of the first five years of the Initiative. The evaluation confirms that goals and objectives were met and activities had measurable impacts and effects on intended audiences.  
• The majority of measureable outcomes built or enhanced alternative, and long-term, approaches to territorial health planning and supported territorial operational and programming changes.
• The evaluation also concluded that collaboration between Health Canada and the territorial governments has resulted in stronger relationships which are expected to continue to support cooperative work to address common goals and interests for health in the territories.

Q5 - How is the THSSI managed?

• The THSSI is overseen by a Federal/Territorial working group made up of Assistant Deputy Ministers from Health Canada and each of the three territories'  Departments' of Health and Social Services.