In the Legislative Assembly on February 21st, 2014. See this topic in context.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

I’d like to call Committee of the Whole back to order. Committee, we last left off with a committee motion on the floor. To the motion. I have Mr. Bromley.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Bob Bromley

Bob Bromley Weledeh

Thank you, Mr. Chair. Very briefly, I support this motion. I’d also like to note that it’s not really just prevention we’re talking about. We have a situation now, so we obviously need a lot of on-the-ground action right now while we are conducting or planning and putting in place a good comprehensive program of both prevention and treatment.

I’d also like to mention that we really should be promoting a dental therapist training program at Aurora College, so I’m hoping that the Minister of ECE is listening and will start to give some serious attention to developing that program, as well, if indeed we don’t have it yet.

I will be supporting the motion. Mahsi.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you, Mr. Bromley. To the motion. Mr. Moses.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Alfred Moses

Alfred Moses Inuvik Boot Lake

Thank you, Mr. Chair. Committee did some hard work going through the business planning session and I feel that bringing motions forward for recommendations that, as chair of the standing committee, I do stand behind the hard work of the committee members, the staff, and the departments that came and presented before us and gave us some of their concerns and issues as well.

As this is a recommendation, I will be supporting the motion. Thank you, Mr. Chair.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you, Mr. Moses. To the motion. Minister Abernethy.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

Thank you, Mr. Chair. Just for some clarity, there is a reference to this, in this motion, to $468,000 which I believe is the $468,000 that was identified in 8-39. Just for clarity purpose, the dollars that are there came from the federal government, and not the entire $468,000 were actually NWT dollars.

We had, out of that $498,000, when you combine the $468,000 and the $30,000 the year before, we had $198,000 of that and then $50,000 of that available to the Northwest Territories. Of that amount, $144,000 had to go to Nunavut and $105,000 had to go to the Yukon. One of the reasons the federal government gave these dollars to us is for the exact reasons that the Member is talking about, in addition to the fact that we know in Canada we have lost the one training institution that does train dental therapists and the federal government wanted the three territories to try to come up with some solutions on how to improve oral health in the Northwest Territories and also to start having some discussions on how we can facilitate some training for them.

The dollars are used and are being used as part of the Pan-Territorial Oral Health Initiative which has been going on for the two years, and from that they’re going to come up with a report that’s going to help inform decision-making as we go forward on how to improve dental therapy services but also just oral health services in the Northwest Territories as well as the other two territories.

We already do a number of things. We have $366,000 dedicated to dental therapy positions in the Northwest Territories, who are an incredibly important position who do treatment as well as public health and oral health for prevention and promotion. We do a number of things on top of that.

Dental and oral health is promoted at regional and community levels through the authorities, and programs such as Lift the Lip and Little Teeth are big campaigns that focus on teaching parents the

importance of good oral care for children zero to five, or Healthy Family programs have oral health and promotion sections, dental therapists are doing incredible work out there, community health representatives and wellness workers are involved in dental oral health prevention, regional nutritionists are doing much of this work as well. Campaigns linked to healthy eating such as Drop the Pop, promotional breastfeeding and early childhood programs are also contributing in this area. Does that mean we’re doing enough? No. We need to do more and we’ve heard that clearly.

But part of the problem with this motion that’s in front of us today is it seems to be suggesting that this $468,000 is something we should duplicate when, in fact, these dollars were not for the provision of these services but was to do an analysis and research, which concludes at the end of this fiscal year.

It is referenced in here that we should use these federal dollars that are coming as part of the $7 million. But as I indicated yesterday, the federal government put really tight limitations on how we can spend those dollars, and at this time we don’t know what those criteria are, but we do know that the three territories did put forward a recommendation for more money, of which we did not get the full funding, for health system improvement, access to specialized tertiary care and pan-territorial innovation. We don’t know that this will fit under there, so this motion might be a little on the premature side.

What we can say is, when we know what these dollars are available for, we will certainly have discussion with committee to help set our priorities. But at this time, to suggest we put $468,000 in, recognizing these tight fiscal times, also recognizing that we are doing things and that we want to do things better and we will work with the three territories to ensure that dental therapists have training available to northern residents, we are going to be voting against this motion at this time.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you, Minister Abernethy. To the motion.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Some Hon. Members

Question.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Question has been called. The motion is defeated.

---Defeated

Committee, we are on 8-17, activity summary. Sorry, before we do so, Minister Abernethy, do you have witnesses that you’d like to bring into the House?

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

Yes, please.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you, Minister Abernethy. Sergeant-at-Arms, if you would escort the witnesses into the House, please.

I would like to welcome Ms. DeLancey and Ms. Mathison back, and the Minister here for returning. Committee, we are on 8-17, activity summary, program delivery support, operations expenditure summary. Mr. Bromley.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Bob Bromley

Bob Bromley Weledeh

Thank you, Mr. Chair. I’d like to speak just briefly to population health and particularly oral health. I understand that there’s $366,000, three positions with GNWT focused on that and I appreciate that. Is the dental surgery facility still operational in Hay River? Thank you.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you, Mr. Bromley. Mr. Abernethy.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

Yes, it is.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Bob Bromley

Bob Bromley Weledeh

Is that part of what the Minister was talking about with these three positions? Thank you.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

No, Mr. Chair. We have dental therapist positions throughout the Northwest Territories and those dollars that I refer to are for the dental therapist positions.

About 50 percent of our positions at this point are vacant. What I was talking about previously in the motion is there’s nowhere to train new dental therapists and this is a problem, and the three territories are trying to come up with a solution that will allow us to provide training to individuals to fill these roles. This isn’t a problem unique to the Northwest Territories, this is the three territories that are suffering from this.

Our dental services for our residents are actually contracted out by the authorities with private dentists who come to the communities who provide dental services. The dental therapists enhance what can be done in communities.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Bob Bromley

Bob Bromley Weledeh

Thanks to the Minister for that additional information. We’ve heard from departmental staff that 85 percent of children under the age of five have cavities in five teeth, very serious dental issues. I got the sense that the Minister is happy to put his additional efforts into planning and that that’s just a situation we have to live with.

Is that the position of the Minister, that he’s willing to accept that statistic and go with the resources we have and hope that we can get resources in the future? Eighty-five percent of Aboriginal children under the age of five. Thank you.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

The provision of dental services for Aboriginal children is actually the responsibility of the federal government and we’re looking at finding ways to encourage the federal government to invest more money in this particular area. We do care very much about our youth. We recognize, without question, that oral health impacts overall health and we will continue to do things to address those issues. But we need to plan

and we need to figure out what the best programs to put in place are, and we will continue to move forward to develop a plan that will help us address oral health across the Northwest Territories.

I don’t think the status quo was good enough, but I would rather have an informed plan than no plan.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Bob Bromley

Bob Bromley Weledeh

Mr. Chair, I would point out that this is not a new situation. This hasn’t just appeared or anything like that.

Moving on, the health and social services authorities administration I see has made a substantial leap this year from the last two years when it’s been almost identical. I’m wondering: is there a particular reason for that? Does that have to do with maybe the shift of shared services staff or something like that? Is there an obvious and apparent reason for that increase? Thank you.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

We’ll go to Deputy Minister DeLancey.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Debbie Delancey

Thank you very much, Mr. Chair. The increase in funding to health service authorities administration is due mainly to funding for a number of new initiatives which includes positions associated with the rollout of the electronic medical records – there are two positions in Hay River and two positions at the Yellowknife authority – funding to Stanton to roll out the Med-Response system; some portion of the new early childhood development funding that is going to the authorities for direct program delivery; some funding that’s going to the authorities that we’re bringing into the TSC because they will now need to cover their chargeback costs; a significant amount of one-time funding to cover the implementation of moving authorities into the TSC; and some new positions to support implementing our shared services for information technology and information systems. Thank you.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Bob Bromley

Bob Bromley Weledeh

Thank you for that explanation. Just in terms of our work with the authorities to come up with a new line of authority and clarity and continuity in the delivery of our health systems across the NWT, where are we at in that? I know we’ve talked about that for many years. Is that something that the Minister has been talking to health authorities about and is there any kind of a time frame in front of us on how we might proceed there? Thank you.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you, Mr. Bromley. Minister Abernethy.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

Thank you, Mr. Chair. As I’ve mentioned several times, we are working and moving forward on this initiative. We are currently doing a number of back office functions. We’re working on shared procurement, shared IT/IS/IM, we’re looking at the territorial physician pool or the territorial physician model. A number of

these things are well in progress and well on the way.

We have been having discussions with committee. We have been having discussions with our Aboriginal government partners, with the JLC, which is the Joint Leadership Committee, which is the chairs and public administrators of all the authorities, as well as the CEOs on how and what needs to be done to bring us into a territorial system that will meet the needs of our residents.

We will be going to communities and having discussions over the next fiscal year. We will be meeting with leadership across the territory over the next fiscal year and we will be figuring out and working closely with committee, as well, on the direction we will take. But many parts are well in progress for the back office and we will continue to move forward, with support of committee.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Bob Bromley

Bob Bromley Weledeh

Thanks for the details there from the Minister and the duplication, apparently. Is there a target date in mind to complete this work?

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

I just want to add one piece that I forgot to mention, and it’s basically the Hospital Insurance and Health and Social Services Administration Act is going to be coming forward with a legislative proposal. That is being drafted now, so we will be coming to committee to have some discussions around that.

Many of the back office stuff is well underway and we hope to make significant progress in the IT/IS/IM sections with Stanton and a few of the other authorities bringing them into a central back office function this fiscal year. Procurement we intend to make progress on. There are a number of the other ones, and I can provide the committee with more detail in writing about where we are with some of these back office functions.

As far as the next steps, we want to make sure we get it right, and it’s going to involve lots of discussion with committee and with residents of the Northwest Territories. We don’t have a real defined timeline, but we would like to make as much progress as we can in the life of this government. We have committed to putting some structure back in those communities and those regions where there are public administrators within the life of this government. Those things are directly correlated and directly related so we’ve got a lot of work to do.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you, Minister Abernethy. Moving on with questions on this page 8-17, I have Mr. Moses.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Alfred Moses

Alfred Moses Inuvik Boot Lake

Thank you, Mr. Chair. Just a quick comment but then I do have one question in particular. The Minister did release this document Measuring Success, the annual report for NWT Health and Social Services. It has a lot of good stats in it, and it just kind of goes to show when we do put money into prevention, promotion and

education that we do get results from our territorial statistics.

Specifically I want to talk to something that came out of this report. In priority 3 it mentions that the number of clients receiving home care in their home community is at 2,071. That’s 168 more than in 2011-2012, and if you average that out to each community in the Northwest Territories, it’s about 62 clients in each community.

My first question is: Does the Minister know how many home care workers we have in the communities and whether or not each community does, in fact, have home care?

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you, Mr. Moses. Minister Abernethy.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

I’d like to thank the Member for the question. Home care is an incredibly important service that we provide in the Northwest Territories through our individual authorities, and we anticipate the demand on home care services is going to grow as we have an aging population and we’re supporting them to age in place.

The Member has averaged out the demand based on a by-community total, which may not be a fair way of splitting or rationalizing how many home support workers are in each community because every community is different, every community has got a different aging population and different people with different needs. I can tell you that we have, by authority, 29.03 positions in Yellowknife Health and Social Services Authority, home support workers, and that includes home support workers, home care nurses and other positions. I’m going to break it down and that should make it a little easier.

In Yellowknife Health and Social Services, we have 6.5 home support workers, we have homemakers rehab aides, we have registered nurses, so home care nurses, 5.6, and then there are some other related types of positions, rehab aides and whatnot. In Fort Smith we have 1.5 home care nurses, 1.5 home care LPNs, 2.75 support workers, and a medical social worker as well. In the Tlicho we have a lot: 12.5 home support workers, home care nurses, related type positions.

There is a lot of detail. It might be better if I just provide the Member with a written breakdown because it’s going to take a long time to go through. If the Member is alright with that, that’s what I’ll commit to do.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Alfred Moses

Alfred Moses Inuvik Boot Lake

I know the importance of home care in the community and I know I did break it down on average just to see what it was in places like Yellowknife and some of the smaller communities that have a lot of our elderly senior citizens who don’t want to leave home and want to live that independent lifestyle in their community. Those are where we see some of the higher per capita

numbers, and I just want to make sure that we do have the services to support them.

Moving forward, I know I had some questions in the House, and it brought me on to seniors, which also deals with home care, but when I was looking at some of the policies and procedures under Seniors Action Plan, since it’s dealing under the territorial health services, the action plan hasn’t been updated. I’m not sure if there has been a report since 2003 on the action plan. A lot has changed since then. That’s been about 11 years. I just wanted to know if the Minister has any indication of when we’ll have a renewed action plan or if we’re going to get a report on some of the things that were outlined in the action plan. As we are getting into a higher senior population, I just want to make sure that’s addressed and we’re taking care of that moving forward and not trying to catch up after the fact.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you, Mr. Moses. Minister Abernethy, the audio did not pick it up, but I think the Member did want a copy of those statistics you offered earlier. Minister Abernethy.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

Thank you, Mr. Chair, and we will certainly provide that.

The strategy that the Member is talking about is an old strategy, and moving forward we are going to be coming forward with a new strategy. It’s going to be informed by the continuing care report that was released just a couple of days ago to Members. That’s going to help inform the direction we take. We will be coming forward with an Aging in Place Strategy. We’re hoping to have that done by March 31st of this year, so that we can share it with

committee. That will help inform how we move forward to deal with the aging population, the number of the individuals that need different levels of support and what types of things we’re going to need to do over the coming years to help people age in place as much as possible. It won’t be just about staying in homes. It will be about the full continuum from staying at home for as long as you can and is reasonable to moving into maybe independent or assisted living and then to more of a long-term care and extended care into dementia, if necessary. We will be coming forward to have those discussions with committee.

At the same time, I would like to say that in partnership with different departments we have updated the Seniors’ Handbook, which identifies different programs and services available to seniors and elders in the Northwest Territories. That’s been updated as recently as 2012.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you, Minister Abernethy. Committee, we are on activity summary 8-17, Health and Social Services, activity summary, program delivery support, operations expenditure summary, $46.490 million. Does committee agree?

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Some Hon. Members

Agreed.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you, committee. Page 8-18 and 8-19 are together. Activity summary, program delivery support, grants and contributions, $24.416 million. Does committee agree?

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Some Hon. Members

Agreed.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you. Page 8-20, information item, program delivery support, active positions. Any questions?

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Some Hon. Members

Agreed.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Seeing none, 8-23, activity summary, health services programs, operations expenditure summary, $209.007 million. Does committee agree? Ms. Bisaro.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Wendy Bisaro

Wendy Bisaro Frame Lake

Thank you, Mr. Chair. A couple of questions here. There is a large increase in grants and contributions and a fairly large increase in fees and payments. Could I get an explanation of what those increases are for, from, to, et cetera?

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you, Ms. Bisaro. Mr. Abernethy.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

Hold on one second.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Page 8-23. Minister Abernethy.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

Thank you, Mr. Chair. With respect to grants and contributions, there have been about six-ish million dollars in increases. I can just walk through some of those. We’ve had some Collective Agreement increases for both the authorities, including Hay River. That’s about $1.9-plus million. We’ve got some initiatives we are working on that are priorities of the Legislature, which is the Midwifery Program expansion, that’s $470,000. We have the Northern Alberta Renal Program, a much smaller amount, $1,000 it looks like in direct program delivery. This is the one-time funding that we’ve talked about to replace the THSSI funding. An allocation of $1.6 million for Healthy Pregnancies, $180,000 there. We’ve got some forced growth as well, contracts with the NWT Med Association for family practitioners. It’s about $789,000. Some additional forced growth around dietary, laundry, housekeeping contract with Stanton, $93,000. Some northern allowance increases, $112,000; Economic Evergreen Plan for program vehicles, $405,000; release of costs of essential services, $306,000; professional fees, $119,000; supplies, $104,000; chemotherapy drugs have gone up $132,000; and then callback and stand-by pay, $1 million.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you, Minister Abernethy. Ms. Bisaro.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Wendy Bisaro

Wendy Bisaro Frame Lake

Thanks for all that detail, maybe a bit too much. I’m trying to understand. This is an increase to grants and contributions and fees and

payments. A lot of the ones you mentioned were increases in what sounds like compensation. Are these contributions to health authorities? Is that why they’re under grants and contributions and fees and payments? Thank you.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

Yes, these are grants and contributions going to the health authorities. Then under fees and payments, insured services for non-NWT residents went up $4 million.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Wendy Bisaro

Wendy Bisaro Frame Lake

That’s good. Thank you.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you. Page 8-23, activity summary, Mr. Bromley.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Bob Bromley

Bob Bromley Weledeh

Thank you, Mr. Chair. A little follow-up here. For this one-time funding, I believe we are responsible, then, for coming up with our own dollars for these services subsequently. What is the plan for that? Obviously the planning would have to take place during 2014-15 if it disappears at the end of that year. Thank you.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you, Mr. Bromley. Minister Abernethy.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

Thank you, Mr. Chair. A number of these items were covered in the THSSI funding that I described yesterday. We’ve put it in 2014-15 and the Department of Finance has agreed to cover these on a one-time basis. The original plan with the THSSI funding, we were always supposed to have an exit strategy. That exit strategy was never fully developed and/or implemented. If we had cut many of these programs that are in place now without having some sort of transition plan, we would have adversely affected these services going to all NWT residents. So we were able to put money in for this year and we have to come up with some sort of plan to move forward on those for upcoming fiscal years.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Bob Bromley

Bob Bromley Weledeh

I believe the THSSI money is not necessarily meant to cover these things. They will be starting again in one form or another. Has THSSI been approved at some point?

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

We’re not sure what the federal government is going to call this $70 million, but THSSI, as we know it, no longer exists. They have given us some broad statements that we were able to get out of their budget statement about what these dollars are intended for, but it doesn’t seem to directly correlate to things THSSI funding in the past. It may, some of it might, but at this point in time we’re not 100 percent sure. When we know and we’re in a position to pursue those dollars, we will certainly be having discussions with committee. I can say they have been very clear up front that no money will flow unless there’s a clear strategy. These dollars are not intended to be put into ongoing programming, but are designed to give us the dollars we need to build a system that will meet

needs. So it’s more short-term funding. It’s not permanent funding in any capacity.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Bob Bromley

Bob Bromley Weledeh

I know some of that was repetitious. I hadn’t got the full picture on that before. Again, there’s nothing new here. The Minister said himself we were to plan this out of our base levels in the past. We failed in every instance. The Minister says we’ve got the same expectations again, but I haven’t heard anything that tells me how we’re going to do that or that we are. It sounds like we’re just going to ignore it again. We’re obviously not thinking about it. I’m looking for something that says, federal government, we’re hearing you. We’ll do the work and this is how we’re going to do it, or we’re going to hang our hat again on the hopes that new money will come forward. We need to know that. What model are we doing here?

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

The Member is correct. We need to make sure we have a plan that includes an exit strategy and that we use these dollars to help improve the system and put structures in place that will control things that the federal government will require. As I said, in the budget address by the federal government, they identified the $7 million over three years for new targeted and time-limited fund to increase health services in the three territories in priority health areas and to reduce reliance on outside health care systems and medical travel. These are the parameters. We will get more detail and as we get more detail, we will sit down with the Finance Minister to figure out how we put in a plan and what programs we move forward with that will meet the targets that they have recognizing that anything we do cannot become part of the base.

It is time limited with the purpose of improving our services in the long term. We need to have a plan, otherwise they won’t give us the money. We need to make sure there’s an exit strategy or they won’t give us the money. I’m confident that we can do this.

This THSSI funding seemed to drag out from the THAF days to the THSSI days and they always said you need an exit strategy. A lot of work was done, but as far as having a comprehensive exit strategy to get away from those dollars, it wasn’t done to the degree that maybe would have been appropriate.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Bob Bromley

Bob Bromley Weledeh

I think it would be great if these dollars continued to come, obviously, but in the meantime it makes me very nervous. We’ve been through this before. We were all in the panic when it happened in the 16th because we are using this

temporary money for basic service delivery. I think we have made some progress. I’m hoping midwifery, for example, is no longer in that one-off funding.

I will leave it at that. I don’t need any more information right now, but perhaps the Minister can

recommit, if he hasn’t already, to work with committee on this as soon as he has information. I would think committee could play a role in contributing towards decision-making on this. Thank you.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

I have already committed to doing that and I agree with what the Member says, we clearly need to have a plan.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Committee, we’re on page 8-23, activity summary, health services programs, operations expenditure summary, $209.007 million. Mr. Bromley.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Bob Bromley

Bob Bromley Weledeh

Sorry, just one more question. As Stanton gets more and more cooped up and people are stumbling on each other and working out of closet space and so on, are we finding that we’re using other facilities more? Are people being sent south more and so on? How are we staying on top of the impacts and trying to mitigate this situation at Stanton Territorial? Thank you.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you, Mr. Bromley. Minister Abernethy.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

Thank you, Mr. Chair. We do prefer to keep our residents in the Northwest Territories and we do have a territorial bed management program that helps us, where possible, keep our residents here in the Northwest Territories. We continue to use services in the South – MRIs, other things – and where load is there, we will send our residents south for programming, but we do our best to keep everybody in the North as much as possible. We don’t offer every service that’s offered in the South, so from time to time our residents do have to go down.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Bob Bromley

Bob Bromley Weledeh

Really the point is here that we only hear about the challenges and kerfuffles when we visit the hospital as committee. I think it would be useful to hear from the Minister some objective assessment of this situation so that we can help him make sure that situation is managed. I’ll leave it at that. Thank you.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you, Mr. Bromley. I’ll take that as a comment. Page 8-23, activity summary, health services programs, operations expenditure summary, $209.007 million. Does committee agree?

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Some Hon. Members

Agreed.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you, committee. Page 8-24, activity summary, health services programs, grants and contributions, $158.361 million. Does committee agree?

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Some Hon. Members

Agreed.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you. Page 8-27, activity summary, supplementary health programs, operations expenditure summary, $27.3 million. Ms. Bisaro.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Wendy Bisaro

Wendy Bisaro Frame Lake

Thanks, Mr. Chair. I just have one question here. During the 16th I know the Minister

was well aware and the deputy minister, as well, well aware that we had a protracted investigation into supplementary health benefits and potentially looking at charging residents a certain amount to access our supplementary health programs.

I’ve certainly heard from some of my constituents, maybe not a lot of them, but I’ve certainly heard from constituents that it’s time that we start not means testing necessarily but charging a small fee for the extra services that we provide as a government.

I’d like to know whether or not the department has any kind of work that they’re doing, or perhaps work that they are considering doing in the future, to look at either charging a service fee for access to services and even pharmaceuticals and/or means testing. Thank you.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you, Ms. Bisaro. Minister Abernethy.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

Thank you, Mr. Chair. This was certainly a big issue in the 16th Assembly

and it’s something that needs to be done. What I have committed to is we will do work on this, but we need to complete a few of our other priorities and make some human resource room to actually conduct the work. If everything is being done on the side of a desk, nothing gets done, and there is a significant amount of good work that we’re doing in the department to improve services to our residents. This does need to be done, but it’s a lower priority for us at this time. But we will continue to research and gather data so that when we’re ready we can make informed decisions on moving forward.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Wendy Bisaro

Wendy Bisaro Frame Lake

Thanks to the Minister. I can appreciate that you can’t do everything. I would like to know where it’s at. In terms of a time frame, is it something that you’ll get to before the end of the 17th Assembly or not? Thank you.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

It’s not in the strategic plan for the 17th Assembly, but it doesn’t mean that

we don’t continue to do analysis and collect data that will help us be informed when the department does move forward with reviewing this more thoroughly. We do have a significant number of projects on the go that are going to improve the health and the care and the future of residents, and those need to be our priority for the remainder of this term.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you, Minister Abernethy. Continuing on with questions on 8-27, I have Mr. Bromley.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Bob Bromley

Bob Bromley Weledeh

Thank you, Mr. Chair. Just one quick follow-up on that. I suppose the biggest recommendation to come out of the exercise from the 16th to me was the realization that we really

want everybody to have other coverage and that that could be tapped into to help protect our resources.

What proportion of the NWT residents have additional coverage and what are we doing to make sure that those that don’t somehow get it to the extent that that’s possible? Thank you.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you, Mr. Bromley. Minister Abernethy.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

Thank you, Mr. Chair. Based on numbers that we’ve had in the past, we know that it is estimated that about 10 percent of NWT residents have no access to supplementary health benefit coverage. So that means the rest – 90 percent – have coverage of some capacity, whether it’s through private insurance, extended health benefits, NIHB, but about 10 percent don’t have this type of coverage.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Bob Bromley

Bob Bromley Weledeh

Thank you. Is territorial coverage, GNWT coverage, included in the 90 percent?

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

Yes.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Bob Bromley

Bob Bromley Weledeh

So I guess what we want to see is those residents get additional coverage that will help protect the territorial resources.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Mr. Bromley, I’ll get you to rephrase that question a little differently. Thank you.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Bob Bromley

Bob Bromley Weledeh

Thank you, Mr. Chairman. My understanding was we wanted to make sure that people had additional supplementary benefits and health benefits coverage beyond the territorial GNWT coverage in order to protect GNWT resources, essentially third-party, and that we were going to promote that. That’s the statistic that I’m looking for.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you, Mr. Bromley, for doing that. Minister Abernethy.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

So, just so I’m clear, what you’re asking is: How many residents of the Northwest Territories do not have third-party employer-provided types of insurance or other supplementary insurances like NIHB? Am I correct?

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Bob Bromley

Bob Bromley Weledeh

That’s correct.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

I don’t believe we have that detail. I do remember in the last government when the supplementary health debate occurred in the House, there was some recognition by the department that we would find ways to encourage people to obtain some sort of third-party insurance, whether it’s through employers or other things. I’m not currently aware of the status of that, but I will talk to the department, I will get an update and I’ll provide that to committee.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Bob Bromley

Bob Bromley Weledeh

To me, again, that was the biggest recommendation that came out of all the work on this in the 16th Assembly, so I’m surprised

that it’s not higher on the agenda here, because I don’t think there’s much cost to that but the benefits are potentially substantial. I appreciate the Minister committing himself to look into it and I hope that it gets some action as well as looking into it. Thank you.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

I’ve committed to having the department look at this and we’ll get back to the Members with some additional detail.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Okay, committee, we are on 8-27, activity summary, supplementary health programs, operations expenditure summary, $27.3 million. Does committee agree?

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Some Hon. Members

Agreed.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you, committee. Committee, 8-28, activity summary, supplementary health programs, grants and contributions, $16.829 million. Does committee agree?

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Some Hon. Members

Agreed.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you. Committee, 8-31. Ms. Bisaro.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Wendy Bisaro

Wendy Bisaro Frame Lake

Thanks, Mr. Chair. I have two questions here and I mentioned it in my general comments, opening comments on this department and I don’t think I got an answer from the Minister. I’m not surprised; there were lots of comments for him to respond to. But I did want to know, I did want to get an update on the efforts to establish child and family service committees. I know the department worked very hard on it over the last two years or so and I know they were struggling to get any kind of uptake from communities. I would like to know from the Minister, do we still have somebody that’s working on establishing those committees or is it something that has fallen by the wayside and maybe try a different tack at a different time. Thank you.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you, Ms. Bisaro. Minister Abernethy.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

February 20th, 2014

Glen Abernethy

Glen Abernethy Great Slave

Thank you, Mr. Chair. This was an issue that came up in the 16th Assembly and I think additional money was put in so that it established committees throughout the Northwest Territories. I know the department has been eager to establish these starting late in the 16th Assembly and certainly into the beginning of

the 17th Assembly, but at the end of the day we

don’t have any and there seems to be very little interest or uptake at the community level.

In principle, by intent, the reason these committees were put into the act is absolutely sound, but there’s obviously a disconnect somewhere in our inability to convince or encourage people to be involved. We have heard from some of the communities what some of the barriers are. Chief, council members and community members are

concerned about the financial legal requirements that communities may have to undertake. Many people are related in smaller communities and potential conflicts of interest exist. We have continual turnover in electoral leadership impacting communities’ priority areas and investments, limited personal and community knowledge and understanding of the current child and family services system. People are nervous and that seems to be the feedback that we’re getting.

I think people believe in the intent but don’t necessarily believe in the structure. I think it’s time that all of us sat down and had a conversation about how do we get back to the intent – maybe the model we’ve chosen is not appropriate – and how do we get back to where we wanted to be, which is that communities have involvement in ensuring that children from their communities stay in their communities as far as is reasonable and safe to do so. Maybe we should start looking at interagency committees as one option.

I think it’s time that we need to rethink this particular structure that we’ve created by legislation because it does not seem to be meeting the need, although the intent is sound. I’d like to get back to the intent and find a new model that works.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you, Minister Abernethy. I’d just like to advise witnesses if they could just tighten up their responses just a little bit. Thank you. Ms. Bisaro.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Wendy Bisaro

Wendy Bisaro Frame Lake

Thanks, Mr. Chair. I want to thank the Minister for that open response. I was asking because that’s where I kind of thought we were. I think the Standing Committee on Social Programs would be quite open to trying to get together and figure out what will work, because we have to do something.

My other question has to do with the increase in contract services on this page. It’s about $6 million, $5.5 million. Could I get an explanation as to what increases in contracts we’re talking about? Thank you.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

I believe I mentioned these in my response to opening comments. Every year we come forward with significant supps for adult and children southern placements. In fact, this year again the Minister of Finance just tabled the supps and those supps include significant asks for actual costs related to adult and children placements. So we are asking for, in this budget, $2.8 million to be added to the budget for adult southern placements and $2.4 million for children southern placements. We recognize that the cost of southern placements is incredibly high and the director of social services has initiated a client-by-client audit so we could start digging into what are the needs of these people that are going south, if there’s a like contingent of individuals, is there an opportunity to find a way to repatriate them, a block

of individuals with similar needs. A person-by-person audit is well over 100 files and it’s going to take a bit of time, but this is an expensive area and if we can find any way to repatriate some of those dollars and people, we’d be better off in doing that review.

In the mean… [Microphone turned off]

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Sorry, Mr. Abernethy. I’ll let you finish up for the record. I don’t think they caught you. Go ahead.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Glen Abernethy

Glen Abernethy Great Slave

I don’t remember what I said.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Thank you, Mr. Abernethy. Moving on with questions on activity 8-31, I have Mr. Moses.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

Alfred Moses

Alfred Moses Inuvik Boot Lake

Thank you, Mr. Chair. I do have a few issues within the community programs here, but rather than get into back and forth questioning, I think what I’ll do is begin with reading in a motion regarding the child and family resources programs and services, please.

Consideration in Committee of the Whole of Bills and Other Matters (Reversion)
Consideration in Committee of the Whole of Bills and Other Matters (Reversion)

The Chair

The Chair Daryl Dolynny

Go ahead, Mr. Moses.