Question Period Note: Home Care and Palliative Care

Canadians want to age at home and receive supports from their community, in the setting of their choice. This is especially true when they have a serious illness or are approaching the end of life. Increased access to high-quality home and palliative care services is necessary in order to help people receive the care they need in the setting of their choice, to allow them to live as independently as possible. Federal actions are working to improve access to home care and palliative care in Canada.

Canadians want to remain at home or in their community when they are aging, have a serious illness or approaching the end of life.
the Government of Canada is currently negotiating “Aging with Dignity” agreements with provinces and territories. These include the remaining $2.4 billion of the $6 billion Budget 2017 commitment for home care and $3 billion over 5 years for long-term care. This is a part of the $200 federal commitment to support the Working Together to Improve Health Care for Canadians Plan.
Budget 2021 announced $29.8 million in funding for the Action Plan on Palliative Care. This is in addition to $24 million from 2019 to 2021 previously allocated for implementing the Action Plan.
IF PRESSED ON ADDITIONAL SUPPORTS FOR AGING AT HOME PROVIDED BY THE FEDERAL GOVERNMENT…
Budget 2021 announced a $90 million investment to launch the Age Well at Home initiative to assist community-based organizations in providing support to help low-income and vulnerable seniors age in place.
The National Seniors Council was tasked with serving as an expert panel to examine measures to further support Canadians who wish to age at home. The Panel undertook several activities to support this work, including an environmental scan, an online survey, and consultations with experts and stakeholders. The National Seniors Council submitted its final report at the end of September 2023. We are currently reviewing this report in detail.
IF PRESSED ABOUT THE ACTION PLAN ON PALLIATIVE CARE …
The federal government has made investments of $54 million to implement Health Canada’s Action Plan on Palliative Care, including initiatives to raise awareness about palliative care and grief; improve palliative care skills and supports for health care providers and others; enhance data and research; and improve access to culturally sensitive palliative care for vulnerable populations.
A public education campaign is underway to raise awareness around palliative care and grief. Phase I launched in March 2023 for providers who are not palliative specialists. Phase II was launched in October 2023 for the public.
IF PRESSED ABOUT PROGRESS ON THE REPORT ON THE STATE OF PALLIATIVE CARE (A LEGISLATIVE REQUIREMENT)
The Act providing for a framework on palliative care in Canada requires that the Minister of Health prepare and table a report to Parliament on the state of palliative care in Canada within five years after the tabling of the Framework on Palliative Care in Canada (i.e., by December 4, 2023).
Development of this Report is currently underway and will highlight progress made by palliative care stakeholders, provincial/territorial governments and the federal government, and other non-governmental organizations.
IF PRESSED ON NSC REPORT & RECOMMENDATIONS…
Health Canada will examine ways to enhance the opportunities for seniors to live independently.
The National Seniors Council, serving as the expert panel on supporting Canadians aging at home, submitted its final advice to the Minister of Health and the minister of Labour and Seniors at the end of September 2023.
These recommendations will be carefully reviewed.

HOME AND PALLIATIVE CARE IN CANADA
Healthcare is a shared responsibility between the Government of Canada and provincial and territorial (PT) governments. While the federal government provides financial support to the provinces and territories for health care services, the responsibility for matters related to the administration and delivery of these services, including home and palliative care, falls within provincial and territorial jurisdiction.
NATIONAL SENIORS COUNCIL/ AGING AT HOME BENEFIT
In October 2022, the former Minister of Seniors and the former Minister of Health have asked the National Seniors Council to serve as an expert panel to examine measures, including a potential aging at home benefit, to further support Canadians who wish to age within the comfort of their own homes.
Earlier in 2023, the National Seniors Council held an online consultation inviting Canadians and stakeholders to share their lived experiences and views on ways to support Canadians in aging at home. Over 12,000 respondents provided invaluable input that will inform the government’s work on this issue.
HEALTH CARE SYSTEM FUNDING
On February 7, 2023, the Prime Minister and his provincial and territorial counterparts met to work together on improving Canada’s health care system. First Ministers discussed shared health priorities to deliver real results for Canadians as well as the importance to uphold the Canada Health Act to protect Canada’s publicly funded health care system.
At the meeting with premiers, the federal government announced it will increase health funding to provinces and territories by close to $200 billion over 10 years, including $46.2 billion in new funding. This amount includes $25 billion to advance shared health priorities through tailored bilateral agreements, building on the $7.8 billion over five years that has yet to flow to provinces and territories for mental health and substance use, home and community care (including palliative care), and long-term care.
In addition, new funding announced includes $1.7 billion over five years to support hourly wage increases for personal support workers and related professions, as federal, provincial, and territorial governments work together on how best to support recruitment and retention.
IMPROVEMENTS IN ACCESS TO PALLIATIVE CARE, BARRIERS STILL EXIST
A 2023 report by the Canadian Institute for Health Information (CIHI), updating their 2018 report, noted that:
• More people are receiving some form of palliative care compared with 5 years ago.
o 58% of Canadians who died in 2021–2022 received palliative care, a 6% increase from 52% in 2016–2017.
• More people are dying at home with palliative support compared with 5 years ago.
• More people are getting palliative care across settings, although it is still often late in life, and some are transferred to hospital when palliative care services may have been available at home or in their community.
• Some people experience greater barriers to accessing palliative care because of their age, where they live or their disease diagnosis.
PALLIATIVE CARE FRAMEWORK AND ACTION PLAN
The Framework on Palliative Care sets out an approach under which all governments, communities, and Canadians play a role in improving palliative and end-of-life care. The Framework was built through participation and direction-setting with key organizations, provinces and territories (P/Ts), other federal government departments and individuals, including people living with a life-limiting illness, caregivers, health care providers, and researchers.
The Action Plan on Palliative Care focuses on the federal role in implementing the Framework. The Common Statement of Principles on Shared Health Priorities (CSOP) and the accompanying bilateral agreements, as described above, outline the way that the federal government and provincial and territorial governments work together to improve home and community care (including palliative care); these bilateral agreements complement the Framework and Action Plan. They show that provinces and territories have invested in the integration of care in the community, digital and IT infrastructure, support for caregivers and palliative care with the CSOP funding.
The first 6 years of the CSOP agreements are complete. The remaining 4 years of funding is currently under negotiation with PTs as part of the Aging with Dignity agreements.
HOME AND PALLIATIVE CARE FOR INDIGENOUS PEOPLES
Budget 2017 allocated Indigenous Services Canada (ISC) $184.6 million over five years with $69.1 million ongoing to improve home and palliative care for First Nations on reserves and Inuit communities. In addition, funding was identified in Budget 2021 for Health Canada to implement the Action Plan on Palliative Care, including funding earmarked for improving palliative care for Indigenous Peoples.
Health Canada is currently collaborating with Indigenous Peoples towards the development of an Indigenous Peoples Palliative and End-of-Life Care Framework. The Framework will include diverse Indigenous voices including First Nations, Inuit, Métis, urban Indigenous people, and 2SLGBTQIA+ and gender-diverse peoples. This work includes leveraging results from relevant engagement processes led by other government departments to reduce engagement fatigue and partnering with Indigenous organizations carrying out Indigenous-led engagement. The resulting framework will provide a road map to guide policy, funding investments and for initiatives to improve palliative care for Indigenous Peoples in Canada.
OTHER FEDERAL INVESTMENTS IN PALLIATIVE CARE
In terms of federal support for research, the Canadian Institutes of Health Research (CIHR), prioritizes investment in research to promote healthy aging and to address causes, prevention, treatment and palliation for a wide range of conditions associated with aging.
Between 2018-2019 and 2022-2023, CIHR invested more than $30 million in palliative care research, including investigator-initiated research (e.g. funded through the Project Grant competition), research in priority areas (e.g., the CIHR Transitions in Care Initiative), and training and career support programs (e.g., fellowships).This includes support for several Canadian Research Chairs who are leading impactful research on topics such as home and community-based palliative approaches, health system innovations, and pediatric palliative care. Through the Networks of Centres of Excellence (NCE) Program, the federal government has also invested $47.8M (between 2012 and 2023) in the Canadian Frailty Network, which aims to improve the care of seriously ill, frail elderly patients/families through the development, evaluation, and implementation of health care technologies.

The Government of Canada is providing $2.4 billion to provinces and territories for the remaining four years of the home and community care Budget 2017 commitment of $6 billion over 10 years. through new Aging with Dignity Agreements.
Budget 2021 announced a $90 million investment to launch the Age Well at Home initiative and $29.8 million in funding for the Palliative Care Action Plan.
Budget 2023 confirmed the Government’s commitment to an increase in health care funding of close to $200 billion over 10 years to support the Working Together to Improve Health Care for Canadians Plan.
In addition to the $2.4 billion for home and community care, it includes $3 billion over five years for long-term care and a federal investment of $1.7 billion over five years to support hourly wage increases for personal support workers and related professions, as federal, provincial, and territorial governments work together on how best to support recruitment and retention.
In October 2022, the Minister of Health and the Minister of Seniors announced that the National Seniors Council will serve as an expert panel to examine measures, including a potential aging at home benefit, to further support Canadians who wish to age within the comfort of their own homes and communities. Engagement with Canadians and stakeholders from across Canada informed the Council’s final advice. The NSC submitted its final report to the Minister for Labour and Seniors and the Minister of Health at the end of September.