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The Canadian government is structured as a confederation with responsibilities for health and social policy being constitutionally delegated to the 10 provinces and 3 territories. The key piece of federal legislation governing requirements for federal financial participation in health is the Canada Health Act that sets forth two categories of service: (1) insured services that include primary medical care and acute care and (2) extended health services that include residential long-term care, home care, adult residential care, and ambulatory health services. Only the insured services are covered by the five principals of the act (universality, accessibility, public administration, portability, comprehensiveness and restrictions on user fees and extra billing). Extended health services are funded through the Canada Health and Social Transfer Act.