Thank you, Mr. Miltenberger. Page 6-9, health and social services. We're still on general comments, so I'll call for general comments from the floor.

Detail. Okay, we'll go to page 6-9. Directorate, operations expense, total operations expense, $6.198 million.

Page 6-13, program delivery support, operations support, total operations expense, $28.595 million. Mr. Roland.

Thank you, Mr. Chairman. Earlier in general comments, I raised the issue of the retention and recruitment section of the department. Seeing under program delivery support there's some mention of recruitment and training here, I'd like to know from the Minister if he's had an opportunity to look at...if he's got numbers that he can provide the committee regarding how many staff have been hired through this recruitment and retention section.

Thank you, Mr. Roland. Mr. Miltenberger.

Thank you, Mr. Chairman. Mr. Chairman, we have numbers that we can offer in regard to nurses that job offers have been made with. We can also give the Member our current vacancy rates that will indicate where we're still short. Thank you.

Thank you, Mr. Miltenberger. Mr. Roland.

Thank you, Mr. Roland. Mr. Miltenberger.

Thank you, Mr. Chairman. Mr. Chairman, we can provide the numbers of staff that have been hired with the assistance of the recruitment and retention unit. As well, we will also, just for general information, provide the latest vacancy rates in the authorities and in the department so the Member can see where we still have problems. Thank you.

Thank you, Mr. Miltenberger. We're on page 6-13, program delivery support, operations expense, total operations expense, $28.585 million.

Page 6-15, program delivery support, grants and contributions, contributions, total contributions, $15.715 million. Mr. Dent.

Thank you, Mr. Chairman. Mr. Chairman, I notice that the amount that we're contributing to health and social services authorities for telehealth coordinators is going up. I was wondering if we could get a bit of an explanation for what the plan is for the expenditures in this coming year.

Thank you, Mr. Dent. Mr. Miltenberger.

Thank you, Mr. Chairman. Mr. Chairman, while we don't have all the funds we would like, we are seeking to put in three new sites: one in Yellowknife, Lutselk'e, Deninu. They won't be the full-scale telehealth sites. They will have video conferencing capability, and we'll get the frame in place for further expansion. Thank you.

Thank you, Mr. Miltenberger. Mr. Dent.

Thank you, Mr. Chairman. Can we get a bit of a snapshot of where we are in rolling out telehealth? I think that Members had been quite supportive of this initiative when it was first announced, with the expectation that we would be able to improve services to Northerners. I think it would be interesting to know how successful we've been at implementing this.

Thank you, Mr. Dent. Mr. Miltenberger.

Thank you, Mr. Chairman. I'll just grab this one piece of information here. Mr. Chairman, we have coordinators for Fort Simpson, Fort Smith, Hay River, Inuvik, and Yellowknife, two in Stanton, which is a total of seven of complete funding. We also have information we provided to committee, which shows the system usage as of April 1, 2002, to December 31, 2002, in terms of the type of usage and the total number of people served, which I can share with the committee once again. I'm not sure if it was given to Committee of the Whole or Social Programs, but I can share that with the committee. Thank you.

Thank you, Mr. Miltenberger. Mr. Dent.

Thank you, Mr. Chairman. I think that information would be interesting. Unfortunately, if it's just being shared with committee it doesn't get into the public realm, so perhaps the Minister could table the information and that way make it public. I know you can't do it today, but perhaps tomorrow you could table it so that the public has some understanding of what is happening.

If I could move on, Mr. Chairman, I notice there's approximately $500,000 going into funding for professional development and retention, over and above what was happening last year. What's this extra half-million dollars going to be used for in the next year?

Thank you, Mr. Dent. Mr. Miltenberger.

Thank you, Mr. Chairman. I'm looking through my notes here. What we've done is we've reprofiled some money. It was part of the recruitment and retention document that was put out. It's going to allow us to do things like professional development, remissible student bursaries, social work, mentorship program, and we got, which totalled I believe, $482,000 in that area. Thank you.

Thank you, Mr. Miltenberger. Mr. Dent.

Thank you, Mr. Chairman. I believe the Minister said remissible bursaries. I thought that a bursary was a grant. Can we get a bit of an explanation as to how the bursary system works?

Thank you, Mr. Dent. Mr. Miltenberger.

Thank you, Mr. Chairman. Mr. Chairman, the intent of remissibility is to help attract professionals coming out of school and assisting them with paying off and paying down any of the costs they may have incurred, and set up a range in the harder to staff communities where the percentage of remissibility is greater than it would be in some of the larger centres. But the whole intent is to try to provide an incentive to attract professionals: nurses, doctors, and other allied health professionals.

Thank you, Mr. Miltenberger. The Chair recognizes Mr. Roland.

Thank you, Mr. Chairman. In the area of contributions to health and social services authorities under professional development and retention, can the Minister inform us who is eligible for this professional development?

Thank you, Mr. Roland. Mr. Miltenberger.

Thank you, Mr. Chairman. Mr. Chairman, it's open to all allied health and social services professionals, and it's going to be based on current job evaluation. It will outline the training requirements based on that particular document being done, it will indicate what's required by the particular employee and profession. Thank you.

Thank you, Mr. Miltenberger. Mr. Roland.

Thank you, Mr. Chairman. Was that fully taken up in the previous year?

Thank you, Mr. Roland. Mr. Miltenberger.

Thank you, Mr. Chairman. Mr. Chairman, that particular program just came into play late in this fiscal year, so we've been working on the uptake and setting up the process to make sure that it is accessed. But it's relatively new in the latter part of this fiscal year. Thank you.

Thank you, Mr. Miltenberger. Mr. Roland.

Thank you, Mr. Chairman. Can the Minister inform us as to how a nurse would be able to take this within the existing conditions they find themselves working in? Thank you.

Thank you, Mr. Roland. Mr. Miltenberger.

Thank you, Mr. Chairman. Mr. Chairman, we have to work with the authorities, and we have been working with the authorities on this particular initiative. One of the issues is, of course, to have the time and the backfill capacity so that nurses and other allied health professionals for social services and health can take that. So it's going to be a management planning function, where if you're doing your job evaluations and you have enough lead time, you have to work with the authorities to make sure that they have the adequate staffing so that when a nurse or an employee goes off on professional development that the service levels are still maintained. Thank you.

Thank you, Mr. Miltenberger. Mrs. Groenewegen.

Thank you, Mr. Chairman. Under contributions to health and social services authorities, just going back to your comment you made earlier in the House today about the discretionary latitude of health authorities to reallocate money within their budget. I'm a little bit concerned about that, because when you talk about having a system that clearly defines the services that are available in any particular community or region, if there are difficulties with staffing in order to carry out certain programs and services, what you're saying then is that that money could be spent on anything else and it kind of undermines the whole basis for the budget process. If health authorities come forward with budgets, there are certain line items in there for certain programs and services. But then when unforeseen things happen such as the inability to staff positions, that money can just be arbitrarily used for something else. I have a problem with that, particularly since health authorities, all except for a couple of them, have been facing deficits. It seems like it might be a deficit recovery. There could be some incentive to not staff positions in order to address deficits. In fact, then the money gets used for something else. It's just kind of a downloading of the costs associated with that service, for example, people having to go to Edmonton or go to Yellowknife to receive those services. Another thing that could occur if it's at the territorial level here, is the example that Ms. Lee gave today, where there's a shortage of nurses in a certain area of service. So people get medevaced, then that doesn't come back to show on their budget, the potential costs of Larga and whatever the Alberta government charges for those services at a different hospital out of territory. So I want to know in your new plans if you have specific measures you're contemplating to address that potential problem with that discretionary latitude. Thank you.

Thank you, Mrs. Groenewegen. Mr. Miltenberger.

Thank you, Mr. Chairman. Yes, we do, Mr. Chairman. We've been working, over the last 14 months or so, to try to better coordinate all aspects of all the authorities and the department to do this together. The issue of adequate and accurate financial information is one that we are still working with. But we are now working on variance reports that come in quarterly. We also have program people tracking expenditures. We have the senior managers of the department and authorities meeting on a regular basis, as well. I appreciate the Member's concern, and it's a concern that I share as well, that we don't want professional development money, for example, that is important for retention, to be used for some other unanticipated expenditures that may not be what was contemplated, putting us at a disadvantage. So we want to, within reason -- and authorities have within reason -- flexibility, but they don't have total latitude. We are working collectively to make sure that we all stay on task and on target. Thank you.

Thank you, Mr. Miltenberger. Mrs. Groenewegen.

Thank you. Just on the subject of deficits and contributions to the authorities, what is the status of the deficits right now and deficit recovery? Stanton's deficit, now that there's no board, how are you planning to address that situation?

Thank you, Mrs. Groenewegen. Mr. Miltenberger.

Thank you, Mr. Chairman. Mr. Chairman, for the most part, the authorities are on track with their deficits. The Dogrib Community Services Board is the one experiencing the most trouble right now. Stanton is also on target. Even though there's no board, the expectation is that they will still comply with the agreement in terms of deficit recovery program. Thank you.

Thank you, Mr. Miltenberger. Mrs. Groenewegen.

So just in terms of Stanton's contemplating deficit recovery actions, so instead of those kinds of directions being provided now by a board, that's just being decided by whom?

Thank you, Mrs. Groenewegen. Mr. Miltenberger.

Thank you, Mr. Chairman. Mr. Chairman, it would be the Stanton staff, through the CEO, working with the deputy minister in his capacity of public administrator. We've indicated as well, I believe earlier, that the Joint Leadership Council also provided at a broad level just that oversight on these larger issues of where we're going with this particular issue and others. Thank you.

Thank you, Mr. Miltenberger. Mrs. Groenewegen.

In terms of following up the progress of how any new plans are going to address this discretionary latitude autonomy by health authorities, where might I look in terms of what part of your plan addresses that?

Thank you, Mrs. Groenewegen. Mr. Miltenberger.

Thank you, Mr. Chairman. Mr. Chairman, I don't have the action plan here, if that's the document the Member is referring to. We are working to better integrate and upgrade all our financial systems. We still don't have capability and a standard financial information system among the authorities. So that is a work in progress, and we will continue to speak to the business planning process as we try to move that particular initiative. Thank you.

Thank you, Mr. Miltenberger. Mrs. Groenewegen.

That's all the questions I have right now. Thank you.

Thank you. Page 6-15, program delivery support, grants and contributions, contributions. Mr. Braden.

Thank you, Mr. Chairman. I'd be interested in following up on Mrs. Groenewegen's line of questioning about the Stanton authority. Is there any position being taken right now in terms of the potential or the possibility of a new board being reinstated in some capacity to help run or help guide the operation at Stanton? Thank you, Mr. Chairman.

Thank you, Mr. Braden. Mr. Miltenberger.

Thank you, Mr. Chairman. It's the intention for the foreseeable future to go with the current system, as we try to focus our attention on the management and responding to the recommendations coming out of the consultant's report. We will get to the governance issue in due course. But at this time, the intention is to focus more on the program side at Stanton. Thank you.

Thank you, Mr. Miltenberger. Mr. Braden.

Thank you. That's all, Mr. Chairman.

Thank you, Mr. Braden. Program delivery support, grants and contributions, contributions, total contributions, $15.715 million.

We'll move on to 6-17, health services programs, operations expense, total operations expense, $118.535 million.

Page 6-19, health services programs, grants and contributions, grants, $50,000.

Contributions, $97.601 million.

Total grants and contributions, $97.651.

We'll move on to 6-21, supplementary health programs, budget summary, operations expense, total operations expense, $14.2 million.

We'll move on to 6-23, supplementary health programs, grants and contributions, contributions, total contributions, $9.849 million.

Mrs. Groenewegen.

Mr. Chairman, I had a question under grants and contributions under the item that was just approved. Am I allowed to ask a question on that?

Does the committee agree?

Agreed. Go ahead, Mrs. Groenewegen.

Thank you, Mr. Chairman. Today in the House, the Minister was questioned on how much money it costs us to recover the co-payment under the medical travel, and that will be an interesting response. I will look forward to that. First of all let's just ask, in a case where the patient does not have the means to pay, is there any provision for financing that $250 co-payment on a temporary basis for people who don't have the cash on hand? Thank you.

Thank you, Mrs. Groenewegen. Mr. Miltenberger.

Thank you, Mr. Chairman. Mr. Chairman, if it's a case of financial hardship, then we have the Indigent Health Benefit Program that is set up to help people in that circumstance. Thank you.

Thank you, Mr. Miltenberger. Mrs. Groenewegen.

Thank you, Mr. Chairman. So the indigent health benefit, I understand that that would be for people on income support and people who could prove that they didn't have sufficient income. What about people who just don't have the money saved up or the cash, but may have the ability to pay if they were given some time or some terms under which to do that? Is there provision for that?

Thank you, Mrs. Groenewegen. Mr. Miltenberger.

Thank you, Mr. Chairman. Mr. Chairman, currently there's capacity and processes in place to bill back people and to arrange payment with them, the key point being that medical travel is not denied. We will work out the keys to get the client to the service, and we have those particular options available. Thank you.

Thank you, Mr. Miltenberger. Mrs. Groenewegen.

Thank you, Mr. Chairman. Well I think that is a good thing, and I'm sure that will also factor into the costs of whatever efforts the government has to take to collect that co-payment. I was just wondering, in the case where the government is unsuccessful in recovering that money, that credit that may be extended to a patient, is it treated as any other type of debt owed to the government whereby if at some time in the future that same person were applying for some other form of government assistance, that that would be denied until such time as that debt was cleared up. I just want to know how strict they are in the recovery process. Thank you.

Thank you, Mrs. Groenewegen. Mr. Miltenberger.

Thank you, Mr. Chairman. My understanding is that it would follow the normal government process of write-offs and forgiveness over the years that it takes to do that. Thank you.

Thank you, Mr. Miltenberger. Mrs. Groenewegen.

Thank you, Mr. Chairman. So say in the unfortunate circumstance where somebody, a single parent is working but not earning very much money and is faced with the unfortunate circumstance of a child, for example, being sick and having to make several trips to Yellowknife or Edmonton and being assisted with that. Then at some time in the future, that same patient applies for student financial assistance for upgrading or something of that nature. I just want to know if that debt would then preclude them from other forms of government assistance or funding at some time in the future. Thank you.

Thank you, Mrs. Groenewegen. Mr. Miltenberger.

Thank you, Mr. Chairman. Mr. Chairman, the Member, in her time in this House, knows as well as I that there is sometimes tremendous latitude when it comes to write-off and forgiveness. Will we hunt down to the ground somebody who owes us $250? I would assume that through this government process that it's there. I know that the follow-up, from my time in committee, on that type of recovery is modest at best. Are we very efficient and effective in terms of our information system and capacity to do that? I don't think so. Thank you.

Thank you, Mr. Miltenberger. Mrs. Groenewegen.

Thank you, Mr. Chairman. Mr. Chairman, I wish the Minister wouldn't refer to what I know as well as he knows. I'm not being paid to answer the questions; he is. So I might suggest that his editorial comment with respect to what I know, he might refrain from. That's all the questions I have right now. Thank you.

Thank you, Mrs. Groenewegen. The Chair will recognize Mr. Bell.

Thank you, Mr. Chair. Also on 6-22, we had some discussion in the last couple of days about the supplementary health program, specifically about the co-payment. Yesterday the Minister had indicated that these were a basket of programs and he didn't want to deal with them piecemeal in isolation. Not his exact words, but that's the sense that I got of it. But he had, in fact, announced that he would be increasing the benefit to Metis health benefits. I think that's a good thing. I think though that there is still this gap that needs to be dealt with, and the Minister has acknowledged that that gap exists. So now it's up to us to find a way to help those folks who are falling through the cracks where the program is concerned.

Mr. Chairman, I guess what I'm looking for here; maybe I should just start with the Metis health benefits. The main estimates don't appear to show any increase in funding, despite the fact that the Minister said as of April 1st we are moving to 100 percent coverage of the co-payment from 80 percent. I'm wondering if I don't understand this, or somehow this is cost neutral, or why the Minister hasn't planned for further expenditures here. Thank you.

Thank you, Mr. Bell. Mr. Miltenberger.

Thank you, Mr. Chairman. Mr. Chairman, this is a demand-driven program, so we've put in what we know the costs are. We know the intent is April 1st to go to 100 percent. We don't have a clear sense to the dollar of what we figure the uptake will be, but we will be allowing for that and funding from within existing resources. Thank you.

Thank you, Mr. Miltenberger. Mr. Bell.

Thank you, Mr. Chairman. It seems to me that even if we took this baseline information -- $404,000 last year -- I assume that's the 80 percent coverage, and they increased it by 20 percent. If we were to assume that the uptake -- and he indicated it's demand-driven -- is consistent, all we need to do is add 20 percent, and it seems that we get a better indication of what this might be likely to cost us. As opposed to saying, well, we're increasing the program, we know it's going to cost more money, we don't know how much exactly so, therefore, we're not going to make any projections. We're going to go with what it was last year and we'll see what comes out of the wash. Doesn't that seem to make more sense, Mr. Chairman?

Thank you, Mr. Bell. Mr. Miltenberger.

Yes, it does, Mr. Chairman.

Thank you, Mr. Miltenberger. Mr. Bell.

I guess I am glad the Minister agrees. We'll move on to the next point then. Maybe the Minister can explain to me a little about the Metis health benefit. I understand it to be third party insurance. It did provide 80 percent coverage of this $250 co-payment will now be 100. As we've indicated - and Mr. Dent spoke to this in his Member's statement today - there is still a segment of society that is not covered, has no third party insurance and is forced to pay for this themselves. I am wondering if we couldn't come up with a third party insurance scheme for those who are currently missed that would allow for coverage of this type of thing exactly. I know the Minister has this discussion paper with four high level options. It doesn't get into that level of detail. We've said scrap the co-payment. Do whatever you want, we just want to see the thing scrapped. But I am wondering if he's considered some sort of third party insurance plan for those who currently aren't covered. Thank you.

Thank you, Mr. Bell. Mr. Miltenberger.