Thank you, Ms. Bisaro. Is the committee agreed?

Thank you. We will resume with that after a short break.

---SHORT RECESS

I will call to order Committee of the Whole. Mr. Hawkins.

Thank you, Mr. Chairman. I’d like to recognize Ally MacInnis on the official record. She’s a Page from Yellowknife Centre and I missed her under recognitions of visitors in the gallery. It’s been my understanding she’s been here almost two weeks as a Page. This is her second round being a Page. I reminded her there are several Members who were Pages, such as Mr. Ramsay, Mr. Abernethy, Ms. Colette Langlois, who is our Clerk, and certainly ourselves, and we can’t forget Mr. Bromley. You never know, she may want to come back someday as an MLA. Thank you very much to Ms. MacInnis for helping us out.

Thank you, Mr. Hawkins. Thank you, Pages, for all the hard work. If committee is agreed, we will go into detail on the Department of Health.

I will ask the Minister if he has witnesses to bring into the House.

I do, Mr. Chair.

Does committee agree?

Thank you, Mr. Chair. With me today on my left is Jeannie Mathison, the director of finance; and on my right, Debbie DeLancey, the deputy minister of Health and Social Services.

Thank you, Mr. Abernethy. My understanding is you had just a few final comments for the general comments.

Thank you, Mr. Chair. We ran out of time on the clock last night before I was able to respond to all of the Members’ opening comments. A number of the Members mentioned THSSI funding. I would just like to talk a little bit about the THSSI funding before we move on.

As I think everybody knows, THSSI was originally funded for five years in 2005 to 2010 and it was extended for two years for 2010 to 2012 and again for another two years, 2012 to 2014. The original intent and purpose of THSSI was to support health reform activities that addressed one or more of the following three broad goals: to reduce reliance, over time, on the health care system; strengthen community level services; and build self-reliant

capacity to provide services in the Northwest Territories.

In 2013-14 we had about $7.53 million available through THSSI which we used for some core programs, things such as the physician staff in the amount of $1.4 million; Stanton Dialysis Program, $98,000; Physician Resident Support Program, $160,000; nursing resources in small communities, $222,000; nurse practitioners, $750,000. We put some money into shared services and system innovation division for $849,000; system initiatives for $854,000; and medical travel, which was a big one, at $3.2 million. Those are the THSSI-approved dollars in ‘13-14.

THSSI ends on March 31, 2014. In recognizing that we had used these dollars to do the types of initiatives that I have just listed, the three territories – Nunavut, the Yukon and the Northwest Territories – put together a business case trying to encourage the federal government to put more money into this particular area. In collaboration with these territories, we pursued a new territorial five-year funding arrangement.

In June 2013 the three territories submitted a business case to the federal government seeking new funding of $90 million over three years. The business case did not request continued funding for the existing THSSI expenditures other than some direct support for the medical travel costs. The business case outlined three proposed areas of funding to be shared by the three territories.

The first was health system improvements, which we are, as three territories, asking for $13 million a year. What we are hoping that we could use those dollars for were improved management of mental health and addictions and chronic disease in our northern context, to maximize efficiency and reduce risk, and develop aging in place strategies.

The second category, we were hoping to get $15 million a year for access to specialized and tertiary care and complex diagnostics, and the three territories are asking basically for $3 million for improved case management and administration of medical travel and $12 million per year to contribute to the cost of essential medical travel.

The third category was pan-territorial innovation, which we are asking for $2 million a year.

According to the federal government’s recent budget, the three territories will be allocated $70 million over three years for a time limited – and this is critical – fund to increase health services in the three territories in priority health areas and to reduce the reliance on outside health care system on medical travel. That’s $20 million short of what the three territories were looking for. I think it’s really important to note that the intent behind the $70 million is not the same intent as THSSI. It is different money.

We have not received any details confirming the federal government’s proposed territorial breakdown for the new funding or the specific priorities that will be funded, what we can use the money for. The budget address says $70 million over three years for new targeted and time limited funds to increase health services in the three territories in priority health areas and to reduce the reliance on outside health care systems and medical travel. We obviously are pleased that the federal government supports ongoing territorial efforts to improve health systems in northern Canada and look forward to hearing these details of the funding and what we will be able to spend it on. One thing we do know is, because it is time limited, they have been very clear that anything we use those dollars for must have an exit strategy. So we cannot put these into permanent programs because we will not have the money on a permanent basis.

As Members know, the 2014-15 Main Estimates that are in front of us today includes proposed funding of $7 million to allow some of the essential base activities to continue in the absence of THSSI funding, including funding for the Medical Travel Program at Stanton and direct service delivery by health care practitioners. Those dollars, as outlined in the budget for ‘14-15, are a one-time allotment to the Department of Health and Social Services. This isn’t ongoing funding, but we have, in this budget in front of us, $1.4 million for the physician staffing model, $116,000 for dialysis at Stanton, $160,000 for Physician Resident Support Program, $322,000 for nursing resources in small communities, $926,000 for nurse practitioners. We also have some money in there for shared services and system innovation division of $1.08 million. There is $3.2 million in there for medical travel. Once again, this is one-time funding this year only and it’s not in the base. The fiscal framework that we are presented with does not provide this funding beyond 2014-15, based on the assumption that we were going to get THSSI.

We have got a new pot which we may not be able to use in the same ways that we have in the past and I don’t believe we are going to be able to use that, so these dollars that we have put in this year, we are going to have to have continued discussions about how we continue to fund these things in the future. Right now future expenditures in this area are not built into the fiscal plan that the Minister of Finance has discussed on a regular basis, so these are additional costs. Should we choose to continue to put money in these areas, which I think is a good idea, it will have to be addressed in some capacity in future years.

So that’s THSSI. We know that we have to find $20 million this year to support the fiscal structure and $10 million more next year, so we know we have some fiscal challenges which are obviously going to be increased as time goes on.

So, that’s just in response to a number of Members who raised THSSI as a point of discussion yesterday.

Thank you, Minister Abernethy. Does committee agree that we concluded general comments for the Department of Health and Social Services? Should we go to detail?

We will go to detail. We will go to page 8-7, department summary, operations expenditure summary… Sorry. Deferred until activity detail or information items are considered. Page 8-8, information item, infrastructure investment summary. Are there any questions?

Page 8-9, information item, revenue summary. Any questions? Ms. Bisaro.

Thank you, Mr. Chair. I want to thank the Minister for the information on the THSSI funding which is about to expire and on the new funding which we are about to get but we don’t know what we’re going to use it for. I was going to ask what the department intended to use if for, but I can appreciate that without the detail. But I am somewhat confused.

Before I go there, if the Minister could provide committee with the information that he listed off about the numbers and so on that THSSI is used for. I don’t know if we have that or not, but it would be helpful if we had that listed, whatever he was reading from.

The Minister stated in his opening comments yesterday, I think I mentioned it in my general comments, as well, that $3.2 million will address a base deficiency in Stanton Territorial’s medical travel budget. I believe I heard the Minister say just now that this is one-time funding. I’d appreciate an explanation of the $3.2 million. He also said $5.2 million has been added to the budget to address the increased costs of children and adult placements outside of the NWT. So, on those two items, could I get an indication of whether or not they are both one-time funding? Thank you.

Thank you, Ms. Bisaro. Mr. Abernethy.

Thank you, Mr. Chair. The $3.2 million that’s in the budget for medical travel this year is the money I was talking about just a couple of minutes ago where we do have money for 2014-15, $3.2 million, but it’s not ongoing. Obviously we need to do some work there.

With respect to the $5.2 million that I mentioned for southern placement for adults and children, and that’s to go to different facilities in the South for

programs and service that are available for our high needs residents here in the Northwest Territories, has been added to the base and it is ongoing funding. Every year we end up coming for significant supps to cover those costs and we’ll be coming at some point this fiscal year to cover those costs. We’re trying to address that in the future by putting that in the base.

Thanks to the Minister for clarifying that. I am very glad to hear that the money has been added to the base for outside placements. That’s something that has been needed for quite a long time.

My last question here on this revenue page is: When the details of the federal funding are known, would the Minister commit to share that information with committee and have a conversation with committee about how the federal money is being used?