Thank you, Madam Chair. We would like to consider Bill 29 and Bill 32.

Thank you, Ms. Bisaro. Does committee agree?

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

---SHORT RECESS

I would like to call Committee of the Whole back to order. We have two small bills in front of us today. Bill 29, Human Tissue Donation Act. I would like to call on Minister Abernethy, the Minister responsible for Health and Social Services, if he would please do his opening remarks on Bill 29. Minister Abernethy.

I am pleased to be here today to discuss Bill 29, Human Tissue Donation Act.

I would like to acknowledge the role that both past and present MLAs have played in spurring this legislation forward. I would like to thank them for their dedication to bringing organ and tissue donation into the limelight and for their support as we continue to move forward on this important initiative.

This bill will replace the existing Human Tissue Act.

We heard Members’ concerns about the current act. We want to ensure that a comprehensive process is in place for NWT residents who wish to donate organs and tissues.

The new act will clarify and modernize definitions and processes for human tissue donation and transplantation and provide the framework for NWT residents to consent to donating organs and tissues.

Unlike the current act, the new act will allow for transplants between living bodies and outlines how residents can consent to the donation of their organs and tissues both during life and after death.

We recognize that donation can be a difficult decision for an individual or for a family to make and that the body should be treated with care, respect and dignity throughout the donation process. The new act also sets out fines and jail

time for individuals guilty of selling body parts or benefitting from the donation of organs or tissues.

Although this act will not establish an organ and tissue donation program, it will allow for residents to register their consent to donate tissues and organs after death through an online registry once one has been established.

The department continues to work with the Government of Alberta to make this online consent to donate registry a reality for NWT residents. We believe that having an online consent to donate registry is important in assisting residents to make their wishes to donate known.

However, it’s also important that residents speak with their family and loved ones about their wishes and ask for their support in case they are in a position to donate but are unable to speak for themselves.

We believe that the new act is a much needed step forward for organ and tissue donation here in the Northwest Territories and we want to keep this momentum going.

As we move forward with this legislation and our work with the Government of Alberta to partner on their online registry, the department will be rolling out an awareness campaign to support and promote organ donation by NWT residents.

I would be pleased to answer any questions Members may have. Thank you, Madam Chair.

Thank you, Mr. Abernethy. I will now call on Mr. Moses, the chair of the Standing Committee on Social Programs to please deliver the remarks that came about as the result of the review of Bill 29. Mr. Moses.

Thank you, Madam Chair. The Standing Committee on Social Programs conducted its public review of Bill 29, Human Tissue Donation Act, on September 16, 2014.

A clause-by-clause review was conducted the same day. The committee thanks the Minister and his staff for presenting the bill.

Bill 29 is intended to replace the Human Tissue Act. It establishes the rules by which consent can be given to use human tissue for transplants, therapeutic purposes, medical education or research. In certain cases the bill requires approval from an independent assessment committee. The bill prohibits medical practitioners from determining death of a donor if they have any association with the proposed transplant recipient. It also prohibits commercial activity in human tissue and facilitates the establishment of inter-jurisdictional agreements.

The committee considered a late submission from Canadian Blood Services. The organization requested that Bill 29 provide the legal framework for the disclosure of personal health information to

an organization which maintains a registry for the donation of body parts or substances. The committee reviewed this matter and can offer assurance that the new Health Information Act will provide the appropriate legal framework. The committee would like to thank Canadian Blood Services for its comments on Bill 29.

Following the committee’s review, a motion was carried to report Bill 29 to the Assembly as ready for consideration in Committee of the Whole.

This concludes the committee’s opening comments on Bill 29, and individual Members may have questions or comments as we proceed. Thank you.

Thank you, Mr. Moses. At this time I would like to ask the Minister if he would like to bring witnesses into the Chamber for consideration of this bill.

Yes, Madam Chair.

Thank you, Mr. Abernethy. Does committee agree?

Thank you. I will ask the Sergeant-at-Arms to please escort the witnesses to the table.

Minister Abernethy, for the record, could you please introduce your witnesses.

Thank you, Mr. Abernethy. Bill 29, Human Tissue Donation. General comments. Mr. Dolynny.

Thank you, Madam Chair. Let me start off by thanking the Minister and the department today for listening to Members like myself and those who brought forward and supported a motion for change. Before I begin my general comments, I wish to remind everyone of the importance of what we are trying to accomplish today by recalling some startling facts.

A single organ donor can save up to eight lives and their tissue can help up to 50 people. With more than 5,000 Canadians on waiting lists for organ transplants, supply definitely cannot meet such demand. This is why, during my time as a legislator of the House, I strongly encouraged my colleagues and the department that we needed to improve this much dated act of 1988 and embarked on a mission of change, change that would modernize our approach to improving our Human Tissue Act with a comprehensive process, a framework and a proper consent process, all the while with the end goal of having all NWT residents having the ability of joining an online consent to donate registry.

Before I go further, it goes without saying, this journey did not start with me but is a continuance of many visionary Members who laid the groundwork for today. Members such as MLA Tony Whitford who, in 1994, tried to persuade Transportation Minister John Todd, who replied then, “It’s impractical.” Then it was Madam Chair herself, MLA Jane Groenewegen, in 1998 with Minister Calvin Ng with a response of, “We’re looking into the possibility of including an organ donation on the back of NWT health cards.” Of course, we know that this never occurred. Then in 2001 MLA Charles Dent raised the issue again with then Health Minister Michael Miltenberger, who announced a task force on organ and tissue donation. It was reported back in the House in August of 2002. Unfortunately, there was no legislative or public record of this task force report or action plan. In 2009, my other colleague MLA Mr. Robert Hawkins raised the issue with Health Minister Sandy Lee with a wavering reply of, “Organ donors or transplants are done in southern jurisdictions.” Finally, in 2013, my colleague MLA Norman Yakeleya, who currently seconded a motion I moved on the subject, who said, “It shows that we’re ready to move forward with a new organ donation plan. Indeed, he was right.”

It takes vision, faith and wisdom to support the necessary steps in improving our systems. My sincere thanks and admiration goes out to these former and current legislative Members who are paving the way for organ donation.

It is important to note that organ donation is, in itself, a difficult decision for any individual or family to make. As we move forward, I encourage all residents to have that important discussion with loved ones.

It goes without saying that I am equally appreciative that, in speaking with many elders throughout the Northwest Territories, we were able to enshrine and respect the cultural sensitivity around this legislation.

I know the department and the Minister share my interest on this legislation. I have utmost confidence they will continue the work needed in conjunction with the Government of Alberta to make this online consent to donate registry a smooth transition for all NWT residents. I know when this time happens, I will be one of the first in line to make that consent a reality.

The experience and preparation for today has been very humbling and extremely emotional for me personally. Amazingly, what started as a journey of bringing forward a private Members’ bill was soon marked with 100 percent support from all Regular Members in a motion of this House and then, finally, a welcoming legislative proposal from Cabinet.

It is interesting how things work out sometimes. Again, in support of this bill today, my many thanks reaches out to every Member of the Legislative Assembly and to the people they represent.

A journey usually starts with a purpose. In my case it started with a promise, a promise to a special northern family and to a very determined little Viking who is able to teach us many lessons. Promise fulfilled. Thank you, Madam Chair.

Thank you, MLA Dolynny. General comments. Mr. Hawkins.

Thank you, Madam Chair. I am going to start by thanking MLA Dolynny for bringing this issue forward in the way he has done. Knowing him for some time, sometimes it does feel longer than just the 15 or 20 years, but he is relentless. The typical spirit he has when he has something in mind and when it’s important, it’s almost one of those things just to stay out of his way. He’s going to get it done. I’m grateful. He really picked up this issue and I can tell you today, we wouldn’t be talking about it without his spirit.

I remember the little Viking he’s talking about and what a situation that was. It was very heart- wrenching for everyone. It’s his family, but it’s also other families that need this opportunity, this gift of life, this gift of hope. This wasn’t won easily, and as MLA Dolynny has said, there are many people who have tried to break ground or make tracks on this issue. I think there’s also a situation maybe as Member Yakeleya said, we were right as in we’re at the right time for it. Like anything, we’re always enthusiastic and want to do things as soon as possible, but sometimes it just takes a while to get there. I want to deeply and sincerely thank MLA Dolynny for being the guy who’s been willing to carry the weight of this journey to now where we are today.

I want to thank the department for coming through and following through on this. This is an important initiative that will bring hope for many Northerners. It’s difficult to say who, because you just never know. You may be the one who needs this assistance. I can tell you the family knowing that mechanisms like this are coming into place, it’s difficult how to qualify how grateful and appreciative they will be. Sometimes just getting an extra month, a year, maybe five or 10 years out of somebody who may be lost before their time is amazing. Like anything, it’s what you do with it.

I’m just going to say this has been a challenging issue. I’m thankful for Mr. Dolynny’s relentlessness on this issue. If it hadn’t been led by him in the support of everyone – because it does take everyone at large – we may not be here today. It was great work. It was fantastic work. Thank you.

Thank you, Mr. Hawkins. General comments. Mr. Bromley.

Thank you, Madam Chair. I would also like to echo my colleague’s comments and thank Mr. Dolynny for his work to bring this to fruition. I’d also like to thank the departments of Justice and Health for doing the work required to get the act to this point. I do agree with the Minister’s comments that Members have been listened to, their concerns have been listened to.

I think the main issue has been to get a comprehensive process in place for those who wish to donate organs and tissues. I’m appreciative of the Minister’s remarks that, although we don’t have our own program for organ and tissue donation, it will allow for residents to register their consent to donate tissues and organs after death through an online registry once one has been established.

I would just like to ask a question on where we are at with that. Is this through Alberta? Are we developing a relationship with Alberta? I know we have some earlier correspondence. Is there an update that the Minister can provide on this as we contemplate this bill? Thank you.

Thank you, Mr. Bromley. Minister Abernethy.

Thank you, Madam Chair. I just want to first start off by thanking all of the Members once again. This is something that was important to me as well as so many of the Members. I am honoured to have been able to carry this across the finish line on behalf of the Members.

We don’t have the ability to develop an online registry here in the Northwest Territories, but given that the majority of the individuals, or actually all of the individuals who will be donating tissues tend to go through Alberta, we’ve been working very closely with Alberta about joining into their online registry. Before the bill was even before the House, I did send the Minister in Alberta a letter outlining our desire to work together and be partners on this. The response back was in the positive that, yes, once we get ours up and running, we would be happy to work with you. They now have their online registry up and running. We’ve been working very closely with them to identify what our needs and expectations are as well as what their needs and expectations are. We have started moving forward to the point where we are actually at the point of costing it, figuring out what the cost will be so that we can move forward quickly in order to get that tool available to residents of the Northwest Territories. At the same time, we’re getting ready to go live with a bit of a marketing campaign to identify, once it’s up and running, what the program is, how you go about registering, how important it is for you to donate, recognizing that it is hard for some people to take that step and actually sign the

registry. We’re hoping, through dialogue and discussion and the types of things that are being brought up by Member Dolynny, Member Hawkins and yourself, as well as MLA Yakeleya, that individuals who start to show an interest and want to learn more about this and then go and get registered online.

So we are making good progress. I don’t have a date at this point in time. It depends on Alberta, but negotiations are going well. Like I said, we’re at a point where we’re getting down to the brass tacks and getting ready to figure out what the costs will be for us to be partners.

Thank you, Minister Abernethy. Mr. Bromley.

Thank you, I’ll leave at that, Madam Chair, and I will be monitoring how fast we can get this into force and get some of these other mechanisms up and running. I appreciate the Minister’s commitment to get that done. Thank you.

Thank you, Mr. Bromley. General comments.

Detail. Does committee agree that we should consider the 25 clauses of this bill in groups of five?

Agreed. Thank you. Bill 29, Human Tissue Donation Act, clauses 1 to 5.

---Clauses 1 through 5 inclusive approved

Clauses 6 to 10.

---Clauses 6 through 10 inclusive approved

Clauses 11 to 15.

---Clauses 11 through 15 inclusive approved

Clauses 16 to 20.

---Clauses 16 through 20 inclusive approved

Clauses 21 to 25.

---Clauses 21 through 25 inclusive approved

To the bill as a whole.

Does committee agree that Bill 29 is ready for third reading?

---Bill 29 as a whole approved for third reading

Thank you, Minister Abernethy. Thank you, witnesses.

Committee, the next item on our agenda is Bill 32, An Act to Amend the Pharmacy Act, and I would like to ask Minister Abernethy, responsible for Health and Social Services, if he would please deliver his opening comments on the bill. Minister Abernethy.

Thank you, Madam Chair. I am pleased to be here today to discuss Bill 32, An Act to Amend the Pharmacy Act.

The bill is straightforward. Through the amendment to the Pharmacy Act, the bill will allow for the establishment of a prescription monitoring program.

The bill will permit the provisions of the Pharmacy Act that establish a prescription monitoring program to prevail over the Access to Information and Protection of Privacy Act.

A prescription monitoring program is a program established to allow the sharing of a patient’s medical information among prescribers, pharmacists and the person with the third-party oversight role, to promote optimal prescribing and dispensing practices for legitimate medical uses.

The program will allow for tracking to monitor if patients are being over-prescribed by receiving multiple prescriptions, or if certain health care professionals are over-prescribing.

The program will assist in early identification of patients at risk for addiction and lead to a reduction in the misuse and abuse of drugs.

I would be pleased to answer any questions Members may have today. Thank you.

Thank you, Minister Abernethy. I’ll now refer to the chairman of the Standing Committee on Social Programs, Mr. Moses, to bring us the committee’s comments in review of the bill. Mr. Moses.

Thank you, Madam Chair. The Standing Committee on Social Programs conducted its public review of Bill 32, An Act to Amend the Pharmacy Act, on September 16, 2014. A clause- by-clause review was conducted the same day. The committee thanks the Minister and his staff for presenting the bill.

The bill amends the Pharmacy Act to ensure that a provision of the act relating to the establishment, administration and operation of a prescription monitoring program applies notwithstanding the Access to Information and Protection of Privacy Act.

Following the committee’s review, a motion was carried to report Bill 32 to the Assembly as ready for consideration in Committee of the Whole.

This concludes the committee’s opening comments on Bill 32. Individual Members may have questions or comments as we proceed. Thank you.

Thank you, Mr. Moses. I’ll now ask Minister Abernethy if he would like to bring witnesses into the Chamber for the consideration of this bill. Mr. Abernethy.

Yes please, Madam Chair.

Thank you, Minister Abernethy. Does committee agree.

Thank you. I’ll ask the Sergeant-at-Arms to please escort the witnesses to the table.

Minister Abernethy, for our records, could you please introduce your witnesses?

On my left is Dr. Jim Corkal, the chief clinical advisor within the Department of Health and Social Services. On my right, Ken Chutskoff, legislative counsel. Thank you.

Thank you, Minister Abernethy. General comments on the bill. First I will go to Ms. Bisaro.

Thank you, Madam Chair. This is a very simple bill, it’s only got two clauses in it, but I just have a couple of questions with regard to clarification. This is going to allow the establishment of a prescription monitoring program and yet that’s not referenced in the bill at all. It talks about the ATIPP Act. So I’m presuming that the details around the establishment of the monitoring program are going to be either in regulation or in policy or something. So I’d appreciate an explanation as to how the prescription monitoring program is going to be described, where it will be described and where it’s going to be recorded.

My other question has to do with basically the safeguarding of info. So the department will be collecting a lot of information about prescribing of drugs and the use of drugs by various patients and clients and so on. How is the department going to safeguard that information and make sure that with a prescription monitoring program those that are monitoring the program are not going to be using the information they’re monitoring in the wrong way? Thank you.

Thank you, Ms. Bisaro. Minister Abernethy.

Thank you, Madam Chair. Currently the Pharmacy Act is subject to the privacy and information sharing rules under the act, Access to Information and Protection of Privacy Act, and ATIPP doesn’t currently allow for sharing of information for secondary use, and because ATIPP prevails, a prescription monitoring program could not be established under the legislation that we have today. But we heard clearly from Members that this is something that’s important, it’s something we needed to do. The new Health

Information Act would have actually allowed us to do this exact thing, but it doesn’t go live until 2015 and prescription drug abuse is something that’s a problem today.

So we felt it was important, based on suggestions and discussions with Members, that we move on this as quickly as we can so that we can begin developing a prescription monitoring program. This legislation simply changes the rules around that particular aspect and gives us the freedom to actually develop a prescription monitoring program that would not breach the different acts that are out there.

So the prescription monitoring program itself will be done and put together by a steering committee that has been developed in the department led by Dr. Corkal and it will engage pharmacists, it will engage other providers who are currently involved in providing prescriptions as well as dispensing medications. We will use different pieces of legislation to ensure that the information is not shared and the rules around the program itself, we’ll make sure that information is not shared beyond the individuals who actually need to access the information. That will include a new position that will be created, a program administrator as well.

So the information will continue to be private and protected and only identified and useable by the individuals who are involved in prescription monitoring program. For some additional details I’d like to go to Dr. Corkal.

Thank you, Minister Abernethy. Dr. Corkal.

Thank you, Dr. Corkal. General comments. Next I have Mr. Dolynny.

Thank you, Madam Chair. Although what we have today appears to be a straightforward amendment to finally allow for the establishment of a prescription monitoring program, it is important to fundamentally understand exactly why we are doing this, what we intend to do with the monitoring program, what will be intended

oversight, what is our role nationally, and finally, what changes should we expect with prescribing and dispensing practices throughout the Northwest Territories.

Now, admittedly, if one was following the evolution of this bill, it could be argued, and I believe it was presented clearly in this House, that the Minister already had the power under the Pharmacy Act in conjunction with provisions under the Access to Information and Protection of Privacy Act of the Northwest Territories and the Personal Information Protection and Electronic Documents Act of Canada to legally direct, use, disclose personal information to this government for statistical purposes just as long as this information did not relate to an identifiable person. For a complete summation of this defence, I would reference replies to the opening address on February 26, 2014, in support.

My purpose today is not to split hairs with the Minister or the department or have any debate on privacy laws in general. What is of importance is that we finally welcome this amendment to the Pharmacy Act so we can bring what is of territorial and national importance, which is responding to the prescription drug abuse in the Northwest Territories or what I’ve referred on many occasions as a sleeping giant of all addictions.

This amendment will finally allow this government a more enhanced legislative framework in addressing prescription drug abuse in general and share in its responsibility when nationally called into action. It is paramount when dealing with addictions the government must be armed with the right information in order to understand the issues and, in turn, positively impact its victims.

This amendment today will finally set the stage of a proper baseline analysis and empirically lead us into the direction of prevention and treatment, monitoring and collective actions.

It is of importance now more than ever we must protect all Northerners from the potential misuse of prescription medications and we must tackle head- on this sleeping giant of addiction and its destructive and fatal power.

Lastly, it is of national importance that we also translate the momentum generated today into action and support our National Anti-Drug Strategy in responding to Canada’s prescription drug crisis.

Again, congratulations to the Minister and the department for listening to the concern of Members, the coroner’s office and the many Northerners in our health field.

Thank you, Mr. Dolynny. Minister Abernethy.

Thank you, Madam Chair. At the end of the day, we want the same

thing, which is to have a prescription monitoring program. Regardless of the fact that we have a difference of opinion on what it takes to get there, at the end of the day we’re there, and this will give us the tools we need to develop the prescription monitoring program that will benefit the people of the Northwest Territories and will be consistent with other provinces and other jurisdictions.

Thank you, Mr. Abernethy. General comments. Mr. Yakeleya.

Thank you, Madam Chair. I’ve also been very supportive and inquisitive of this Pharmacy Act, because I’m looking at the small communities like Colville Lake. We have what’s called a nursing station with a person that’s been trained to work in the communities and administer pharmacy medication from time to time to the elderly people. Is this system then hooked up to somewhere in Colville Lake, like, if they’re trying to prevent any further use of pills that could be seen as harming the person more than helping them? For example, in Colville Lake, is this through the pharmacy shops here or the health centres in the larger centres like Good Hope and Norman Wells? I guess I’m just trying to figure out the crux of it.

Maybe that could be discussed later on, but ensuring that some of the challenges to operate a nursing station in the small communities is not quite as in the larger centres. I just want to ask that, the monitoring of these medications. Do we have enough technology infrastructures in Colville Lake to say Mr. Joe is taking a little too much here, what’s going on. Or is that from the medical field or the pharmacists? Is there some kind of red light that goes on, saying that this is too much here? What’s happening? What’s going on? I just wanted to ensure that people in Colville Lake could also be assured and secure that this monitoring and tracking of prescription drugs could be also beneficial to them. Some of the older people, they don’t question, they just take the pills and sometimes they sit there all day with numbness because they don’t know the effects of some of their pills. That’s all I want to ask. Thank you.

Thank you, Mr. Yakeleya. Minister Abernethy.

Thank you, Madam Chair. The monitoring program itself will monitor drugs listed in the Controlled Drugs and Substances Act. It doesn’t include all medications and it doesn’t include across-the-counter non- prescription medications.

We will be working with pharmacies to develop the program. We will be working with other professionals to help us develop the program, and it will monitor those particular controlled substances. Those controlled substances, for the most part, come out of pharmacies, but there are hospitals

that do dispense some and there are health centres across the Northwest Territories that do dispense some based on a very prescribed formulary that exists in each of the health centres. The intent is to track the dispensation of those controlled substances.

Thank you, Minister Abernethy. Mr. Yakeleya, you are good? General comments. Any further general comments?

Detail. Okay, thank you. I will refer our colleagues to Bill 32. An Act to Amend the Pharmacy Act. Clause 1. Agreed?

---Clauses 1 and 2 inclusive approved

Thank you. To the bill as a whole. Agreed?

Does committee agree that Bill 32 is ready for third reading?

---Bill 23 as a whole approved for third reading

Agreed. Thank you. Bill 32 is now ready for third reading. Thank you, Minister Abernethy. Thank you Dr. Corkal and Mr. Chutskoff. I will ask the Sergeant-at- Arms to please escort the witnesses from the Chamber.

What is the wish of the committee? Ms. Bisaro.

Thank you, Madam Chair. I move that we report progress.

---Carried

I will now rise and report progress. Thank you, committee.