What scope of evaluation are you going to use when you are taking analysis of this into consideration?

I believe there is a formal review process on this. An RFP ran out not too long ago. I believe it’s closing in June. I’d be happy to undertake to get the Member the terms of reference and all of the details on that.

Can I assume the details are not known, but that things like staffing levels will be part of that analysis?

Things like staffing levels, perhaps. That sort of analysis doesn’t require a formal review. That’s being undertaken under the medical travel review. I think that as we are working in this fiscal environment, looking at balanced budgets and the pressure on the system, the department is constantly working with the authority about the staffing levels and how to optimize those.

Does the Minister agree that if the staffing levels were not up to whatever service level that should be provided there, or they should be extended to the next level of service...? Would the

Minister not agree that at times there might be a situation where people are choosing not to make a call but rather choosing the path to call a medevac to deal with a problem? Would that not be a consideration as to maybe why the resources of a particular area may want to be into question and, therefore, linked to the medical travel analysis as she’s trying to figure out why it’s so expensive?

The Territorial Medical Travel program that’s being evaluated right now is a pan-territorial agreement agreed to by the territorial/federal/provincial working group as a part of the THAF program, because, as Members may be aware, there has been additional funding provided to all northern jurisdictions on that medical travel issue.

As to the Member’s question about there being more medical calls because there’s understaffing in the communities and such, I think the Member should know there are quite a few people working in medical travel, working with the regional centres and health clinics. When there is a need for medical travel involved, doctors are involved, nurses are involved, and there are lots of authorization processes to go through to get those. I think that might be a separate issue.

Operating under the precautionary principle, one would assume that if a person is just an RN in a particular health centre, and their abilities, as I think I’ve understood it, are not as high as an NP…. You know, an NP makes different calls on being able to deal with a situation, and they are able to administer certain elements of a drug therapy, as opposed to maybe an RN whose skill level isn’t as high, as I pointed out, as an NP, and therefore may not be able to offer that service. So what they end up doing possibly — and I’ve heard this as a scenario — whereas both the professional levels…. It’s not a question of competency but their professional levels. They’re able to cause them to communicate with a doctor. Then again, back to that cautionary principle, the call is then made to say, “Well, we’re not sure, but we think let’s just send this person in,” because that’s the safest process.

That’s why I think the human resource level at these areas should be considered at the same time. Are we staffing them to the appropriate level? Is there an NP in every health centre? I don’t know. I think maybe that should be examined. Whether we can staff it or not, that becomes a different type of question. But the fact is: are the resources there at the appropriate level?

Has there been any analysis that the Minister can provide as to how often, and where, most of these medevacs — things such as medevacs, that is — are coming from? Does she rate the community? Do they track how many per community?

Thank you,

Mr. Hawkins. Mr. Cummings.

Would they not want to consider that human resources should not be part of that consideration and strategy when you consider that evaluation?

I guess, in the larger sense, that is true. I do get what the Member’s trying to get to and point to.

As I stated, the evaluation is very specifically to that medical travel. But in the larger picture of how we could improve the medical travel policy we have, we are undertaking that. That’s part of the wider work we are doing at Stanton. One of the biggest programs they have is the Medical Travel program. As a part of the restructuring process, we are looking at it. In that sense, obviously, we will look at the human resource component of that. I will report to the committee and the Members on the findings.

Thank you, Minister Lee. We’re on page 6-29, Activity Summary, Supplementary Health Programs, Operations Expenditure Summary: $20.869.

Department of Health and Social Services,

Activity Summary, Supplementary Health Programs, Operations Expenditure Summary: $20.869 million, approved.

Moving on to page 6-31, Activity Summary, Supplementary Health Programs, Grants and Contributions, Contributions: $12.459.

Department of Health and Social Services,

Activity Summary, Supplementary Health Programs, Grants and Contributions, Contributions: $12.459 million, approved.

Moving on to page 6-33, Activity Summary, Community Health

Programs, Operations Expenditure Summary: $75.334 million. Mr. Bromley.

Yes, thank you, Mr. Chair. We’ve heard a lot in our discussions of priorities and goals and objectives and so on about dealing with the need for additional addictions treatment. We’ve particularly highlighted the need for aftercare services in the communities. I’m wondering how that is reflected in this budget.

Minister Lee.

The aftercare program is a part of the entire spectrum of the programs we provide in that area. I don’t know if that part is under this area. I’ll ask Mr. Elkin if it’s in this area or in another section.

Thank you. Mr. Elkin.

I didn’t quite hear that. I assume that means it’s coming up yet. Okay. I see treatment and rehabilitation services for addictions, mental health and so on is part of this activity. I assume it’s the appropriate one here.

Thanks for those comments. I’m wondering what the increase for aftercare services would be in the communities provided for in this budget — the new ones, the new focus in this area, as per our priorities, if there are any, for people who have received treatment outside the community and are returning to the community.

We don’t have a separate budget item that says aftercare or treatment care or pre-care or anything like that. There are a number of funding grants and contribution numbers under 6-35, which is for money we paid to organizations. We should also remember that under mental health and addictions specialists and community wellness workers, our employees in communities are working but their salary is not included in here, per se. A part of their work is to work with people who might have gone away for treatment and are coming back, or they work on the aftercare part of that. I don’t think this budget book is laid out the way Mr. Bromley might have thought of.

I think I’ll just wait until we turn the page again and perhaps push through this more.

Thank you,

Mr. Bromley. Ms. Bisaro.

Thank you, Mr. Chair. I did want to ask — I think it belongs in here; I couldn’t find, really, where else it might go — about the

emergency services funding mentioned by the Minister in her remarks somewhere along the line.

There is $150,000 for emergency services funding. It’s a program that’s being done in conjunction with Municipal and Community Affairs. I wondered if I could get some information.

I think I asked the questions yesterday. If this is a joint project, I would like to know how much money MACA has budgeted for this project, and what the total funding is for this particular project, which, from what I understand, will enhance emergency services ground ambulance and so on, for communities to deal with accidents and ambulance requirements outside of their communities.