Nova Scotia Premier Darrell Dexter, the host of the Council of the Federation gathering, said he and his colleagues will tackle everything from crafting a position on disputed health transfers to the development of a pan-Canadian energy plan.
But he added that much of the talk between the provincial and territorial leaders will be tinged by frustrations over their increasingly distant relationship with the prime minister, who last met with them three years ago.
"There is a fair amount of consternation about the question of engagement between the federal government and the provinces ... That's going to be a very lively topic for this meeting," he said in an interview before the three-day meetings begin Wednesday.
"The federal government needs us to deliver the services that are of most importance to Canadians and, at some point, they have to come to us and discuss how that's going to take place."
That consternation centres on a series of federal decisions the provinces contend were made with little to no consultation, such as changes to employment insurance, the omnibus crime bill and reforms to the Fisheries Act.
High on the list is Finance Minister Jim Flaherty's announcement late last year that health transfer payments would increase at six per cent annually until 2017.
After that, the transfers would be tied to the rate of economic growth and inflation — currently estimated to be about four per cent — but the government wouldn't let the amounts fall below three per cent.
Provinces including Quebec, Ontario, Nova Scotia, Manitoba and Newfoundland and Labrador said Flaherty imposed the deal on them without leaving room for negotiations. But the federal government has said the new formula is generous.
Several Eastern provinces with small but increasingly elderly populations have said the scheme will result in punishingly high costs.
"(If it goes to per capita), P.E.I. is destroyed," Premier Robert Ghiz said before the Halifax meeting.
"The feds aren't listening to the experts and the experts are the provinces because we are the ones delivering health care in Canada."
Ghiz will deliver a report he co-authored with Saskatchewan Premier Brad Wall on new ways to meet health challenges, including the needs of seniors, patients with chronic diseases and northern populations. It will look at scope of practice, clinical practice guidelines and human resources in the hopes that they can share ideas about improving the delivery of health care.
Premier Greg Selinger of Manitoba is expected to present a study he took on after the last meeting of premiers in Victoria in January on federal fiscal transfer payments.
The premiers are also expected to discuss moving ahead with a national energy strategy being led by Alberta that would form a common approach to developing, marketing and sustaining energy resources.
The Western premiers are already backing the vision put forward by Alberta's Alison Redford, who was in Toronto last week to meet with Ontario Premier Dalton McGuinty and has held one-on-one meetings with other premiers in the run-up to the council gathering.
Many of the leaders have insisted publicly that their divergent regional interests and varying energy resources won't get in the way of any kind of unified front, a sentiment endorsed last week by a Conservative-led Senate committee that recommended a national approach to energy.
"The provinces may have different ambitions in terms of what they're trying to do, but a comprehensive energy policy won't take a portfolio approach," Dexter said.
"We're a big country and there's a going to be different approaches in different parts of the country, all of which can be equally valid and supportable."
But some say that might be overly optimistic if agreements don't come with incentives.
Harvey Lazar of the Institute of Intergovernmental Relations says the provinces succeeded in pressing Ottawa to restore fiscal cash transfers in the late '90s leading up to the health accords years later.
"History suggests that it is easier for provinces and territories to make common cause when they all stand to benefit immediately," he said.
"Each premier has a unique electorate and each province a unique economy. It is far from obvious that the premiers can or should even try to make common cause on issues that affect their economies differently, like EI or energy. It is not their task to be the national government."