This is page numbers 4463 - 4502 of the Hansard for the 16th Assembly, 4th Session. The original version can be accessed on the Legislative Assembly's website or by contacting the Legislative Assembly Library. The word of the day was health.

Topics

The Chair

The Chair David Krutko

Thank you, Ms. Bisaro. More of a comment. Mr. Minister, do you want to respond?

Michael Miltenberger

Michael Miltenberger Thebacha

Thank you, Mr. Chairman. I appreciate the sentiment. The issue is going to be as we look at this supplementary for all the other costs for health, is going to be identifying the funds to make the initial transfer. Thank you.

The Chair

The Chair David Krutko

Any other questions? Health services programs, not previously authorized, $4.269 million.

Some Hon. Members

Agreed

The Chair

The Chair David Krutko

Supplementary health programs, not previously authorized, $600,000.

Some Hon. Members

Agreed

The Chair

The Chair David Krutko

Community health programs, not previously authorized, $2.283 million. Mrs. Groenewegen.

Jane Groenewegen

Jane Groenewegen Hay River South

Thank you, Mr. Chairman. Something that has always been of concern to me is the amount of money that we

spend on facilities in the South. There are two items here, one is for increased costs associated with children in residential care outside the Northwest Territories and the other one is the increased costs with adults in residential care outside the Northwest Territories. I know that we went some distance toward our ambition to repatriate some adults with the assisted living facility in Hay River and they have the capacity for 10 full-time residents or clients in that facility, but it seems like the demand for these southern services continues to grow and I would like to know what the government’s response is to that and what opportunities for further consideration of offering care, opportunities, options for these folks in the Northwest Territories so they are not going south, which, if they require specialized treatment and care, I am still of the belief that we have the ability to recruit and retain and attract workers here with the kind of skills that they would need.

I see it as advantageous to keep residents in the North, as well, for reasons of closeness to family and reduced travel costs, and just the fees that are charged for these kinds of placements seem very, very high. So I would like to ask the Minister what kind of discussions or thoughts are had in response to these kinds of increased costs. Thank you, Mr. Chairman.

The Chair

The Chair David Krutko

Minister of Finance.

Michael Miltenberger

Michael Miltenberger Thebacha

Thank you, Mr. Chairman. These particular circumstances with children in southern placements and adults are constantly being assessed. There is a changing variety of presenting problems, multiple needs, many in high need categories, and the challenge is that you may only have one or two clients that have very specific high needs that can only be met in a specialized facility. If you have a number of those clients across a number of very expensive facilities, it limits our ability to meet all those different needs under one program area.

We did take a look at this, as the Member pointed out, with the adult assisted living campus in Hay River. We did manage to repatriate. The other challenge is, of course, that as we repatriate, we do have needs in clients, both children and adults, that require services that aren’t available. As we have done over the years, we have slowly built up our program base. We have assessed these and we have built facilities, we have repatriated and we are struggling with the complexities of some of the problems as well as the demand that has yet to level off. Thank you.

Jane Groenewegen

Jane Groenewegen Hay River South

Does the Minister have numbers available as to how many adults and how many children are currently... This is just an appropriation for additional funds. Does the Minister have a number of people that are in care, adults and children, and what the total cost is? Because I

don’t think we are seeing the full picture here. Thank you, Mr. Chairman.

The Chair

The Chair David Krutko

Minister of Health.

Michael Miltenberger

Michael Miltenberger Thebacha

Mr. Tolley.

The Chair

The Chair David Krutko

For FMBS.

Tolley

Thank you, Mr. Chairman. On the children in care, projected for 2009-2010, we have, I guess there is a minimum and a maximum number that we are depending on at any one time, but the average is about 35 children in care. The total number of months is about 501 months. Total expenditures projected for 2009-2010 would be a little over $4.6 million. On the adults side, projected for 2009-2010, we have 46 adults in care, 2009-2010 projected expenditures of just over $7 million. Thank you, Mr. Chairman.

Jane Groenewegen

Jane Groenewegen Hay River South

So these are fairly large numbers. I don’t know how they compare to previous years, however, the Minister has indicated that the demand for southern referrals and placements is increasing and I don’t know what is contributing to that. He said there are emerging issues, but certainly in terms of the sustainability of the support that this requires, it would be good if we knew what those emerging issues are so that we could perhaps do something to kind of put prevention or stem the increase in some way, because I’m not sure if this number in this group of people who are in need of these specialized services, I’m not sure this is sustainable over a long period of time if this continues to grow. So what were those emerging issues that the Minister referred to? Thank you.

The Chair

The Chair David Krutko

Minister of Health and Social Services.

Sandy Lee

Sandy Lee Range Lake

Thank you, Mr. Chairman. For the children, the numbers have stayed quite stable since 2004-05. The average number of children in care back then was 39, the next year it was 39, and the year after, 36. We are projecting for 2009-10, 35. So those numbers have stayed the same. The number of adult placements has increased over the last number of years, but it was 27 in 2004-05, then 29 the year after, 35 in 2006-07, the year after, and then 48 in 2007-08, 51 in 2008-09, and 46 is projected.

Mr. Chairman, the people that are placed in these facilities are usually from either severe disability and who require care that we cannot provide in the North, or mental health disorders and other behavioural issues. I can assure the Member that we don’t know exactly why the numbers are increasing, but much of the cost has to do with not so much the number but the cost of care, because lots of these institutional settings have increased their rates. Also, we do review every file and, in fact, when we opened the Hay River assisted living facility we reviewed every file that was down south

to see if we could repatriate them. We have repatriated some of them and since then we have been able to avoid placing adults down south because we were able to direct them to Hay River.

This is something that is under close scrutiny in the department to make sure that we don’t use out-of-NWT placements unless we absolutely have to. Thank you.

Jane Groenewegen

Jane Groenewegen Hay River South

I didn’t really hear any answer. I guess the Minister said she doesn’t know why the number of placements required, what’s kind of contributing to that need for specialized services in southern Canada. I’m glad to hear that the department is keeping a close eye on that, not that we want to deny or deprive anybody of specialized services if that’s what they need, but when you look at the cost of care and these costs can be anywhere from $250,000 to $450,000 per client per year, and you look at that over the course of a person’s lifetime as an adult, if there’s no change in their conditions, I guess I just, again, say that we need to, as a government, look at some of the contributing factors to people’s condition that they require this care. Because this is a lot of resources that are absorbed by this and, like I said, not that we want to deny or deprive anyone of specialized care, but I’m looking at it from how is this sustainable in view of all the other demands on our financial resources. That’s just more of a comment. Thank you.

The Chair

The Chair David Krutko

More of a comment. Minister of Finance.

Michael Miltenberger

Michael Miltenberger Thebacha

Thank you, Mr. Chair. Once again, I appreciate the Member’s comments. Her observations, I think, are accurate, as well, in terms of the ongoing health care costs, and the issue of sustainability is a huge challenge for every jurisdiction. Thank you.

The Chair

The Chair David Krutko

We’re under community health programs, not previously authorized, $2.283 million.

Some Hon. Members

Agreed.

The Chair

The Chair David Krutko

Total department, not previously authorized, $8.288 million.

Some Hon. Members

Agreed.