This is page numbers 6621 – 6658 of the Hansard for the 17th Assembly, 5th Session. The original version can be accessed on the Legislative Assembly's website or by contacting the Legislative Assembly Library. The word of the day was services.

Topics

The Speaker

The Speaker Jackie Jacobson

Thank you, Mr. Abernethy. Final, short supplementary, Mr. Hawkins.

Robert Hawkins

Robert Hawkins Yellowknife Centre

Territorial-wide, territorial-wide, the growth in five years in seniors is going to be at 150 percent. All the beds that have been created today and all the beds they think that they’re going to create tomorrow still won’t meet that demand. The Minister

can say we’re going to shuffle seniors

around the room, around the territory to solve the problem. It is not meeting the challenge.

Will the Minister just be honest in this House to say are they going to make an agreement with Avens and when, because they cannot wait any longer. I can’t wait any longer. The seniors can’t wait any longer. As I started, and I’m going to finish, this tsunami of seniors is on our doorstep and they’re crashing away because they’ve got nowhere else to go. They demand their government to act.

Glen Abernethy

Glen Abernethy Great Slave

As the Member indicated in his opening comments and following up with his questions, Avens is a territorial facility and it has a number of people from across the Northwest Territories. As we make beds available in Norman Wells, as we make additional beds available in Behchoko, we do believe, and we have a fairly solid understanding, that some of these individuals will move. That will take off some of the temporary demand on Avens, but it doesn’t eliminate the demand. I’ve acknowledged that today.

We are working very closely with Avens. We will continue to work very closely with Avens, exploring all the possibilities and financing options. We’re committed to getting this done and we will get this done. There will be an expansion to Aven Pavilion, and we believe it will be done in the appropriate

time, given resources, timing and agreements with Avens.

The Speaker

The Speaker Jackie Jacobson

Thank you, Minister Abernethy. The Member for Deh Cho, Mr. Nadli.

Michael Nadli

Michael Nadli Deh Cho

Thank you, Mr. Speaker. My questions are to the Minister of Health and Social Services. Addictions and its effects in the NWT are a big problem. It’s sad to see many of our people struggle, and like many, we are compelled to try to do something. Chief Roy Fabian and his council on the K’atlodeeche First Nation were trying to do that. We have an unused and empty facility on that reserve.

Will the Minister commit to working with Chief Fabian and his council to consider reopening the treatment centre? Mahsi.

The Speaker

The Speaker Jackie Jacobson

Thank you, Mr. Nadli. Minister of Health, Mr. Abernethy.

Glen Abernethy

Glen Abernethy Great Slave

Thank you, Mr. Speaker. In 2011 the Nats’ejee K’eh Board funded an organizational review, which made many observations about the issues at the facility that impacted negatively on programs, clients and staff. We worked closely with the board to try to find some solutions. Unfortunately, they were unable to implement any of the solutions to improve the situation there.

In 2013 the executive director advised that no further intakes should take place due to the risk of client safety in that particular facility. When that happened, we were in no other position than to withdraw funding from that facility and prioritize it into other areas that it was going to meet immediate demands.

We recognize, as I said the other day, that the people of the Northwest Territories want a continuum and a range of services, including on- the-land

programming,

community

treatment,

community

counselling-type

treatment

in

communities. We’ve offered the Matrix program and we have contracts with four southern facilities that are providing those services that we’ve never been able to get through facility-based treatment here in the Northwest Territories.

Having said all that, I have been working with the chief of the KFN to try to find a solution for that building. We’ve funded them $44,000 to hold a workshop in 2014 where they brought residents from across the Northwest Territories together to discuss possible options, not including a treatment facility but a wellness centre, a training centre for mental health and addictions, a spiritual centre for Aboriginal people, as well as possibly the home location of what will be the future of a mobile treatment option. All of these seem reasonable. We

discussed those with the chief at the time. Even the chief, at the time, indicated that they did not want to open a facility; the facility they had had too many challenges and even their board were the ones who directed that it be shut.

I’m absolutely interested in having a relationship with KFN to find a way to use that building outside of a dedicated treatment facility and we will continue to work with KFN to do that. Thank you.

Michael Nadli

Michael Nadli Deh Cho

I’d like to thank the Minister for his

reply. Can the Minister expand the fundamental issues in terms of having customized made-in-the- NWT treatment programs? Can the Minister explain to this House the cost deficiencies in terms of having customized addictions programs here in the NWT versus sending people down south? Mahsi.

Glen Abernethy

Glen Abernethy Great Slave

Thank you. At any given time here in the Northwest Territories, even when Nats’ejee K’eh was in fact opened as a territorial treatment facility, we have approximately 12 people in treatment at any given time. As I explained earlier this week, we have 12 people going out and they’re going to a wide range of programs that we haven’t had in the past. Nats’ejee K’eh offered one sole program. We have a women’s facility; we have a men’s facility; we have a facility focused on narcotics and other drugs.

What we do know is at this time those facilities in the South are costing us around $150 a day for a wide range of programs we’ve never been able to offer, whereas Nats’ejee K’eh was costing us $420 per person per day, which is significantly higher for a very limited program where people and clients were not safe. Thank you.

Michael Nadli

Michael Nadli Deh Cho

In the NWT we pride ourselves on made-in-the-North solutions and we always try to be independent in terms of trying to aspire to make things work here for us.

Why can’t we have our own people treat our own people in addictions to help them recover and at least reach a productive life in communities and in the NWT? Mahsi.

Glen Abernethy

Glen Abernethy Great Slave

We do do that. As I indicated, when the Minister’s Forum on Mental Health and Addictions went out, we heard a number of things: made-in-the-North solutions, on-the-land programming, community counselling, all sorts of different options. People wanted a variety and a range of programs. Facility-based treatment is only one of those options.

We

provide

money

to

different

Aboriginal

governments

and

organizations

around

the

Northwest Territories to have custom made, regionally specific, culturally appropriate made-in- the-North programs for our residents and those programs are seeing some positive results. We also have community counselling positions and many NGOs who are doing incredible work across the

Northwest Territories with a real focus on the North. We also have programs like the Matrix, which are community-based treatment programs with no facility that are being delivered around the Northwest

Territories

by

Northerners

for

Northerners.

We have responded to the Minister’s Forum on Mental Health and Addictions, which was very clear, a wide range of programs, options that are available and we have moved down that road.

I still think the facility, the Nats’ejee K’eh facility, has a great opportunity to provide some service, whether it’s a wellness centre, whether it’s a training centre, whether it’s a spiritual centre of some capacity, something that is going to benefit all people of the Northwest Territories, and we’re open to having those discussions with KFN. We just don’t feel that, at this point, re-establishing it as a treatment facility that has failed over and over again is going to provide any benefit to the people of the Northwest Territories. Thank you.

The Speaker

The Speaker Jackie Jacobson

Thank you, Mr. Abernethy. Final, short supplementary, Mr. Nadli.

Michael Nadli

Michael Nadli Deh Cho

Thank you, Mr. Speaker. It’s very

clear and there’s no denying that we have a huge addictions problem in the North.

Will the Minister admit that we do have a problem and that the treatment centre is one solution and that the treatment centre should be reopened? Mahsi.

Glen Abernethy

Glen Abernethy Great Slave

There’s no question

that we have challenges here in the Northwest Territories with mental health and addictions. Addictions is rampant throughout the Northwest Territories, and in direct response to the Minister’s Forum on Mental Health and Addictions, we’re taking the actions that were directed by the people of the Northwest Territories, who said support on- the-land programming, get community counsellors in the communities and regions, make sure that we have a wide range of programs and options. Treatment facilities are but one, and in the Northwest Territories, treatment facilities have failed every time that we have tried to open one. They’ve failed because of staffing reasons, high cost, $420 per day compared to southern facilities at $155, safety issues that were clearly articulated, and underutilization.

These facilities in the South are run and successful because they can maintain a very, very large number of clients at any given time. Poundmaker’s can take between 80 and 100 people, which helps them bring in psychologists, psychiatrists and permanent staff who can really work with the clients. We don’t have that capacity. So I’m not going to commit to reopening Nats’ejee K’eh as a treatment facility. I will commit to working with the community to finding a use for that facility

that will benefit all people, something like a wellness centre, a training centre for mental health and addictions, or a home location for what will be our mobile treatment option at some point in the future, but not reopen it as a treatment facility again because we’ve failed and we’ll continue to fail. We don’t have the capacity. Let’s do something that’s actually for the benefit of our people rather than just result in another failure. Thank you.

The Speaker

The Speaker Jackie Jacobson

Thank you, Mr. Abernethy. The Member for Hay River South, Mrs. Groenewegen.

Jane Groenewegen

Jane Groenewegen Hay River South

Thank you, Mr. Speaker. My questions are for the Minister of Health and Social Services as well. In my Member’s statement today, I talked about a scenario that could occur where a non-medical escort accompanies a patient to Stanton, or I suppose it could be to Edmonton, and they get there and the programed treatment for the patient changes for some reason and the person who is the non-medical escort, out of the goodness of their heart, has probably taken time off work and is there doing this as an unpaid service.

When the program changes and the person who is the escort needs to go home, what are their options for that cost being covered? Thank you.

The Speaker

The Speaker Jackie Jacobson

Thank you, Mrs. Groenewegen. Minister of Health, Mr. Abernethy.

Glen Abernethy

Glen Abernethy Great Slave

Thank you, Mr. Speaker. When an individual travels as a medical escort with a patient, there’s an expectation that they will stay with that particular person. We do know that we have people going out for really long periods of time and we actually have a policy that says after 21 days escorts can swap out and we cover those costs. However, if an escort wants to leave before the designated swap-out person, they are technically on the hook for recovering the costs.

Now, we do recognize that the situation the Member is describing has happened and can happen. So, we do have an extenuating circumstances policy in place that says if you go and something happens, like the patient’s stay is extended and it adversely affects the escort, we can work with them to make sure tha

t they wouldn’t

necessarily have to pay back. But if they choose and there are no extenuating circumstances, they’re on the hook. Thank you.

Jane Groenewegen

Jane Groenewegen Hay River South

That is good news to hear, that under extenuating circumstances the escort could find a way home at the government expense. If an escort is only accompanying a patient for a procedure or a surgery or something that’s only anticipated to be a day or two, they may have agreed to it on those grounds, but if it turns out to be a longer period of time, how would that

escort then, without having to pay out of their own pocket, access that return ticket? How would they do it? What’s the process? Who is going to determine what the extenuating circumstances are? How long is that going to take to get approved? Those sorts of things. Thank you.

Glen Abernethy

Glen Abernethy Great Slave

As in all cases, we would obviously need some confirmation from the medical practitioner that the patient’s reality has changed. So the individual would have to work with the patient to get some recognition from the practitioner which could then be shared with the medical travel staff who can actually facilitate the return ticket or rebooking. How long it takes really depends on their ability to get the information to the medical staff, but we can make those things happen pretty fast. Thank you, Mr. Speaker.

Jane Groenewegen

Jane Groenewegen Hay River South

How much latitude does the person who works in medical travel who issues travel tickets have and are they aware of the discretion they have? In a real life case that I know of, t

he escort was told, “I’m sorry. If you’re travelling

home without the patient, you are on your own hook,” and at the last minute they needed to get home and had to pay full fare for their ticket and so on. So, are the people who issue the tickets in medical travel aware of the fact that they can approve return flights under those circumstances? Do they have the authority to grant that? Thank you.

Glen Abernethy

Glen Abernethy Great Slave

We are trying to ensure that all of our staff are up to date, they understand the policies, they understand the policies that exist.

We are actually doing a medical travel review and modernization to improve the medical travel experience. One of the things that we’re doing is focusing on client service and making sure that all of our medical travel staff have gone through and are certified as customer service agents, which means they will be able to work better with our clients.

In the case the Member is describing, I would certainly be happy to look at it to make sure everything worked out, or

if it didn’t, we can fix it to

make sure it doesn’t happen again. We are trying to ensure our staff are trained. We are trying to ensure they understand the policies. We are trying to ensure they know what latitude they have. But at the end of the day, everything around medical travel is going to require some sort of medical practitioner’s recommendation for changes, so we still need to make sure that the medical system is involved. Thank you, Mr. Speaker.

The Speaker

The Speaker Jackie Jacobson

Thank you, Mr. Abernethy. Final, short supplementary, Mrs. Groenewegen.

Jane Groenewegen

Jane Groenewegen Hay River South

Thank you, Mr. Speaker. Like so many other government policies, this one

needs common sense and it needs flexibility because there are probably lots of times when somebody is going to be an escort for a patient, if they are going for 21 days or more, in all likelihood it may not be practical or it may not be necessary for that escort to stay with that patient for that entire time. It may just be required that they travel with them, make sure they are delivered into the hands of a health care practitioner down there and they may not need someone to stay. You’re not travelling with the patient so your expenses aren’t covered isn’t a very good answer from medical travel

. I don’t know what my question is, except let’s

make it real, let’s make it common sense and let’s make it simple. Thanks.

Glen Abernethy

Glen Abernethy Great Slave

I agree completely. That’s what we are trying to accomplish through medical travel modernization. We want to have clear rules. We want to make sure people understand their obligations under the rule and understand the Medical Travel Policy, that they understand their roles, both as a professional and as a recipient and that it has the human component built in. Thank you, Mr. Speaker.