Yes, Mr. Chairman. I’m pleased to present the Department of Health and Social Services Main Estimates for fiscal year 2008–2009. The department’s mission is to promote, protect and provide for the health and well-being of the people of the Northwest Territories. To achieve the mission, the department has the following goals:
•
to promote healthy choices and responsible
self-care;
•
to protect public health and prevent illness and disease;
•
to protect children and vulnerable individuals from abuse, neglect and distress; and
•
to provide integrated, responsive and effective health services and social programs for those who need them.
The department is requesting an appropriation of $309
million, an increase of approximately
$33 million over last year, which is an 11.7 per cent increase.
The proposed budget is allocated to five main areas of activity:
•
$175 million for health services programs that include public health, chronic care clinics, in-
patient and out-patient care, and physician services;
•
$75 million for community health and social
programs that promote healthy lifestyles and community wellness and services for at-risk individuals and families;
•
$31
million for program delivery support,
including $12.5
million for authority
administration and $7.2
million for specific
recruitment and retention and training initiatives system-wide;
•
$21 million for supplementary health programs, including medical travel and extended health benefits; and
•
$6.7 million for system-wide support.
The department is proposing critical capital and information technology investment of $34 million, including:
•
a consolidated primary care clinic in
Yellowknife;
•
the addition of seven beds to the Northern
Lights Special Care Home in Fort Smith;
•
the completion of the new adult supported-
living facility in Hay River;
•
a new territorial dementia facility in Yellowknife;
•
a major renovation to the Fort Smith Health Centre;
•
minor code upgrades to existing infrastructure, including the Territorial Treatment Centre, Woodland Manor Long-Term Care Facility in Hay River;
•
evergreening of major medical equipment; and
•
investments in electronic health records
management and imaging archive technology to improve health service delivery, in partnership with Canada Health Infoway.
Mr. Chairman, the 2008–2009 budget for Health and Social Services continues to follow the direction outlined in the department’s strategic action plan. We’re proposing to focus our resources to continue to improve services to people, support to staff and trustees, system-wide management accountability, and development of the integrated service delivery model.
This budget proposes an increase in spending for Health and Social Services to reflect the cost of delivering these critical and valued services to residents of the NWT.
The $33 million increase is comprised of:
1) strategic
investments
;
2) forced growth for services provided within the
NWT;
3) new federal funding for specific health and
social services initiatives; and
4) increased cost of services provided to NWT
residents in the south.
Strategic Investments
As a first step in re-evaluating how we deliver health and social services, a number of initial investments are being proposed, including:
•
$571,000 for the new supported-living facility in Hay River; the total cost of the facility operation will be offset by repatriating eight clients currently in the south;
•
$224,000 for respite services for families with special needs, to establish three regional programs outside of Yellowknife;
•
$800,000 to collaborate with Education,
Culture and Employment to support existing shelters and enhance community services;
•
$150,000 to collaborate with Municipal and
Community Affairs to develop legislation and a framework for ground ambulance and highway rescue services;
•
$100,000 to collaborate with MACA on the
Healthy Choices Framework to promote healthy living; and
•
$1 million for the standardization of foster care rates.
Reductions
To be able to reinvest in transformational changes of the Health and Social Services system, the department examined the programs and services it is currently delivering to determine how to change the way services are currently provided and to identify efficiencies that could be realized.
For 2008 and 2009 these include:
•
reducing Tele-Care promotion costs, now that it has been implemented;
•
changes to delivery of Telehealth services,
while pursuing partnerships with Canada Health Infoway for enhanced services in the future; and
•
reduction of Health and Social Services
recruitment and retention initiatives to match current spending levels.
Earlier this year the department underwent a functional realignment to better support the Health and Social Services system as a whole. In support of this process, a number of positions are being proposed to be eliminated, to reflect the refocused role and function of the department. As part of the government-wide realignment initiative, the department has identified 17
positions in
Yellowknife to be eliminated. This represents a 12.7
per
cent reduction to the current
133
department positions: 118 located in
Yellowknife, and 15 located in Inuvik. This will result in ongoing savings of $1.6 million starting in 2009–2010. Due to the timing of the reductions, this will result in savings of approximately $400,000 in 2008–2009.
Forced Growth
As a front-line service delivery department, a majority of the Health and Social Services budget is for personnel costs. As a result, much of the annual forced growth is for compensation-related costs. The forced growth for the delivery of services within the NWT includes:
•
$7.8 million for increases in fixed costs related to compensation, including collective agreement increases, position re-evaluations, pension liability and relief staffing in hospitals;
•
$1 million for supplementary health benefits for forecasted cost increases in 2008–2009;
•
$4.7 million to support costs related to the
delivery of front-line services at the community level, such as fuel costs; non-governmental organizations; electronic health records and electronic medical records systems’ operating costs; physician services; purchased services contracts to provide support services in our hospitals and at the community level, such as dietary, laundry, leases, laboratory services, et cetera.
Federal Funding
The budget also includes drawdowns of short-term federal funding for specific initiatives:
•
$1.8 million for Patient Wait Times Guarantee, to support community health nurse training, nurse practitioners, and EHR/EMR legislation development;
•
$3.1 million for year three of five of the
Territorial Health Access Fund, for long-term reform to invest in front-line services such as nursing resources in small communities, midwifery, dialysis, physician support and training, and home and community care.
Mr. Chairman, the Department of Health and Social Services has historically been the recipient of time-
limited targeted third-party funding, primarily from the federal government. These often result in public expectations for ongoing programs once the funding sunsets. The department is acutely aware of the implications associated with this type of funding. Examples include:
•
The Territorial Health Access Fund (THAF) for long-term reform is scheduled to sunset on March
31, 2010, resulting in an annual
reduction of $4.3 million.
•
The Patient Wait Times Reduction Guarantee Trust, totalling $4.6 million over three years, also sunsets on March 31, 2010.
The department, in collaboration with the governments of Nunavut and Yukon, is developing an evaluation framework for THAF, along with the federal government, to attempt to extend this funding beyond 2010. However, as with other funds there is no guarantee that additional funding will be provided, so the GNWT must incorporate the sunsetting of these funds into its planning framework.
Southern Referrals
NWT residents are referred to southern Canada, primarily Alberta, for a number of acute and specialty services not available in the NWT. These costs are driven both by the volume of NWT residents requiring referrals, and the price of services in the south.
Due to the variable and unpredictable nature of these demand-driven costs, the department has historically been required to return for supplementary funding near the end of the year, once the full costs are known.
In the past two years the supplementary funding received for these services has been $7.7 million and $5.6 million.
For 2008 and 2009 the proposed budget has included this funding up front in the Main Estimates to minimize the need to return later in the year for a supplementary funding request, including:
•
$5.1 million forced growth for out-of-Territories hospital and physician services and southern residential care.
•
An additional $4.7 million for out-of-Territories hospitals, reflecting a dramatic increase in national in-patient and outpatient rates. Effective April 1, 2008, the interprovincial per diem rate across Canada increased approximately 30 per cent.
•
$2.1 million for increased costs related to air medevac services to transport NWT residents
as a result of the current market conditions and increased fuel costs.
That concludes my opening remarks, Mr. Chairman. I would be pleased to answer any questions Members have. Thank you.