Just a clarification, have we concluded 8-12? Mr. Yakeleya.
Thank you, Mr. Chair. Just an update from the Minister in terms of the facility planning designs. I know she’s heard from my region in terms of several facilities and I want to ask her again, for the record, to outline the process if we can see something within this government plans to build a regional wellness centre. And also, the elders were looking at an elders home in the Sahtu.
Maybe before we go on, I would just like to point out to Mr. Yakeleya, the elders home situation will come up under 8-30 with regard to care services for elders. So that question could be asked in that area, but I will allow the Minister to answer your question. Ms. Lee.
Mr. Chairman, I can say just from the statement that the Member made, part of Foundation for...action plan is to do an inventory of facility needs to look at the inventory and the status and shapes of our health centres and health care facilities, also looking at long-term care needs of our residents in the Territories.
We know demographically we are going to need about 38 to 40 beds in the Territories over the next little while and it will be up to us to make a decision as to where that would go and I know that Sahtu is looking at that. So that’s where we are with the inventory, doing the facilities review. Thank you.
Under the directive on 8-12, it talks about facility planning and you also made reference to another section I could look at is the elders facility, I guess. I’m asking the Minister in terms of planning for a facility in our region, so you know this region here, the Sahtu is the only region that doesn’t have any type of regional facility like a wellness centre or emergency centre or even an elders centre for the region. So that’s the focus that I am looking at in terms of this department looking at planning for facilities. I know there is a need for other facilities to be upgraded as I heard other Members talk about their own regions, however, we haven’t one building that we could say that this is the regional facility for us in the Sahtu, so that is how I look at the facility planning.
The Minister has come back and said -- and certainly she is right -- it has to be up to the Members to give their vote to which one they are going to look at and I guess that is part of rolling the dice, I guess, in the Legislative Assembly, in how you get your needs for facilities met. I also hear from my region that people want to come back to the Sahtu that are in Yellowknife or Inuvik or Fort Simpson. They want to come back to the Sahtu, so I guess I want to make note to the Minister that this issue is still alive and well and I am not going to put it away anywhere. This is for my people.
I take the Member’s point that part of this paper is just to describe the function of the directorate which does facilities planning. I understand that there is quite a need for long-term care facilities and some other renovations for facilities in health care centres, and that is something that we will be discussing further with the Members and will be looking at community needs to see where to locate this as we move forward in the capital planning process because it is, as you understand... We need to establish the need, we need to get planning money and then work through our capital budget process. Thank you.
I certainly appreciate the Minister’s response to the process as to how the capital planning process is established and what we agree to, and I was just wanting to make sure that when the needs come up in terms of the facilities for the people, like any project, the Sahtu has some serious considerations. I don’t want to list off some projects that are questionable as to how they got onto the capital process and the funding to operate those facilities. I am not here for that. I am here to see if we can get our projects, such as the ones I listed. There are other communities also going to ask for assistance in their regions. I want to make a comment to the Minister. Thank you, Mr. Chairman.
I take his comments. It is well taken. I hear him. Thank you.
Next on the list, Mr. Bromley.
Thank you, Mr. Chairman. Mr. Chairman, I wanted to ask what role this department is taking in developing the government’s response to the Joint Review Panel recommendations. Obviously, a number of them call for planning and even facilities to enhance our delivery of health care and, of course, these will require commitments for resources, both people and dollars, and I think is the directorate that would be dealing with this. If not, maybe the Minister could highlight who would be dealing with it. It seems like it would be a big issue that we should be engaged in at the professional level within the department in order to put together a good response and plan for the future. Thank you.
Minister of Health and Social Services.
Thank you, Mr. Chairman. As the Minister of Environment and Natural Resources indicated, ENR is the lead department, but there are deputy ministers across departments working to provide the input into the response. At the department level in Health and Social Services, the deputy minister is involved in the response. Thank you.
Thank you to the Minister for those comments. I presume part of that participation is a financial sort of scoping exercise and I am wondering... It seems a pretty aggressive schedule that has been set for a response and our various committees are on record wanting to play a significant role in developing that response. Will the Minister be bringing that information as it is being put together to committee, either in written briefings or in person when possible, so that we can fulfill that role that the committee has expressed a desire for? Thank you.
Our response will be coordinated through the Minister for ENR. That is how, I believe, we will proceed. Thank you.
I guess, just on the financial scoping side of it, that is something that obviously would be useful for us in our considerations early on. I am assuming again that that is happening, but perhaps I am just expressing an interest for that being brought forward. I think we wanted a role in both developing as well as responding to the final draft response of the government, so I am seeking opportunities to make sure that goes forward on that basis. Thank you.
As the Minister of ENR indicated, this is quite new still, new in the process. It is massive, it is substantive, it needs a lot of work. I want to state that we are, our department is involved at the deputy minister level to provide the input and whatever else is needed. Included in that would be our expertise on the delivery of health care and social services, which is obviously a part of the recommendations. So without going into the details of that, because ENR is coordinating it, I think we could say that the department is involved in all aspects of the response through ENR. The Minister of ENR wants to respond.
Minister of Environment and Natural Resources, Mr. Miltenberger.
Thank you, Mr. Chairman. I just wanted to point out one of the factors we are going to have to work around is the fact that three of the Members, Mr. Bromley being one of them, are registered as interveners and there are legal considerations as we go forward briefing MLAs and such. We honour our legal requirements in terms of access to information, treating all interveners the same and it has been pointed out to us that we have to be prepared to work around that consideration as well. You, Mr. Chairman, and Mr. Yakeleya, I believe, are registered as interveners, so it just adds another complication that we have to work around as we do our work, to make sure we are seen to be playing on a level playing field with all the other partners since we are a responding government. Thank you.
Mr. Bromley.
Thank you, Mr. Chairman, and thank you for the comments from both Ministers and I certainly, for one -- and I am sure the other interveners -- want to stay squeaky clean, so I appreciate the guidance there. Has the Department of Health received a schedule for their input to the Minister of Environment and Natural Resources on the response timing? Mahsi.
Ms. Lee.
Thank you, Mr. Chairman. I don’t know if I can add anything more than what I have already said. We are involved. We are part of the responding process for the government through Environment and Natural Resources. Thank you.
We are on page 8-13, directorate, operations expenditure summary, activity summary, $5.975 million.
Agreed.
Clarification, $5.957 million.
Agreed.
Page 8-14, grants and contributions, directorate. Mr. Menicoche.
Thank you, Mr. Chairman. This is with regard to the line item, of course, aboriginal translation services. There was, it looks like, $5,000 allocated previously in 2008-09, nothing in 2009-10, nothing in 2010-11. Can the Minister explain why that is not there, especially given the length that this Legislative Assembly has been working with regard to aboriginal languages? Thank you.
Minister Lee.
Mr. Chairman, I believe that this is more of an accounting issue. The $5,000 denotes a one-time payment through a contribution agreement to Tlicho Community Services Agency for the Tlicho Healing Wind Sexual Health Terminology Project. The goal of the project was to reduce the incidents of STI in the region. It was a one-time program funding. It was marked in the books for 2006-09 and it would no longer continue, but it doesn’t speak to our programming in language services in the department. It will come later on, I believe. Thank you.
Mr. Chairman, if the Minister can point out what page number that is on, I will have a look at it then.
Mr. Chairman, I will send him a note. Thank you.
You can get in trouble passing around notes in this House. Mr. Menicoche. Mr. Yakeleya. Grants and contributions, directorate, activity summary. We are moving on to page 8… Mr. Hawkins.
Thank you, Mr. Chairman. Under the primary care division, would this be the area that is under the program delivery that would cite areas for diabetes care and treatment? Thank you.
Mr. Hawkins, we are just finishing up 8-14. Do we conclude 8-14?
Agreed.
We are on page 8-15 under directorate, active positions, information item.
Agreed.
Program delivery support, activity summary, operation expenditure summary, $31.936 million. We are on page 8-17. Mr. Hawkins.
Thank you, Mr. Chairman. My same question stands. Is this the same area under primary care division or public health division where we get into the diabetic treatment? If so, what programs are being presently offered and what new programs are being contemplated in this budget cycle year? Thank you.
Deputy Minister Meade.
The role of the department is to set the long-term vision and the standards and the delivery of this is carried out by the authority. Under the Foundation for Change, we are looking at the key disease states, chronic disease states that can be best managed at a community level, can be best managed through self-care and can be handled within our acute system. Diabetes falls under that because we have a population need as well as how we can better deal with it. Health care is very integrated so while there is a role for the diabetes treatment standards and where the program will fit, there is also a role in the authorities around the management. This group works very closely with authorities but also in the setting of nursing standards and guidelines. So diabetic care like other things would fall under that.
You talked about new. That will be in how we start to manage and set goals under chronic disease management. But, yes, in general, primary care, health care nursing standards and some of the key disease groups fits there.
Mr. Chairman, I appreciate the deputy minister reading out the flow chart, but what would be new in the sense of developments and new programming and treatment for diabetes for this year? Thank you.
Minister Lee.
Mr. Chairman, that is part of the Foundation for Change Action Plan. We are looking to enhance our chronic disease management programming and that includes treatment of diabetes and prevention of diabetes. I don’t know if the Member is asking for a precise dollar amount, but this is something that is done in every authority. Our primary care nurses and health care workers are involved in that. Thank you.
It wasn’t meant as disrespect. Are we talking about running new programs for treatment for specifics of diabetes? At this time, as I understand, we are not sending people out or we are avoiding sending people out for treatment for those types of things who have received treatment. They are being told now that they will offer acute care. When I refer to acute in the sense is specific to their needs here whether it is a system with weight loss, the system with specific treatments, things of those types. It is my understanding there is no rollout right now. I am trying to get a sense exactly what new programs are envisioned that will treat these types of problems, if we are choosing to not provide these services at this time.
If I may further augment my point, we have people who have been denied services who go back as far as November in my particular concerned area, but, furthermore, I am sure that there are other community areas where people have sought diabetic treatment follow-up to care that they have been receiving in Edmonton. So now they are being told they will receive it here in Yellowknife. They are very concerned, and so am I, as to what care and services will be provided. I suspect at the rate we are moving, nothing, of course, will be approved until the new budget plan, which means April 1 at the earliest. What exactly will we be looking for, just so I can follow along? The Minister in her recent letter to me said there will be a follow-up as to what this exactly is. I thought maybe now is a good time as any to be able to help address the situation.
This affects young people and elderly people. I think it is an interest not just of mine but many other Members in this Assembly, because many of us have constituents who have diabetic problems. I think today is probably a good time to sort of dive right into that type of detail to find out what we are, as far as the dollar amount goes, I don’t really care at this particular time. I want to know what programs are going to be offered to our constituents. Thank you.
Deputy Minister Meade.
Mr. Chairman, I think this is a good example of how medical testing, diagnosis and care evolve. It evolves very quickly, based on science. Many of the things we used to do in hospitals we now do as outpatient or in clinics or in a doctor’s office. With the treatment of diabetes, it has been quite evolving. A lot of it is moved to self-care and clinic-based issues. What was happening was some of the treatments were seen by specialists. For those we now have nurses currently being trained. In fact, the person that runs the dialysis unit connected to some of the diabetes out of Hay River has been in Stanton doing training. We are cross-fertilizing across this whole Territory with our specialists so that we can increase both nursing and other training. Stanton has currently got a review on the best way to deal with some of the diabetic support services, nutritional counselling, et cetera. So is it new programs or is it evolving programs as we are able to push some of this out to communities.
I am not aware specifically of stopping diabetic services in Edmonton, but there is more and more of an ability to have some of that done both with specialist support to telehealth, to our providers and to more of our providers to be trained to do this at home. It is also evolving. It’s an example of how the medical profession evolves in some areas to deal with this early testing, self-management and the use of technical and other innovative supports to manage this. I think it’s an example of where, whenever we can, we should provide services within the Territories. Thank you.
Thank you considerably for that excellent answer. That’s the type of information I was trying to get at: what do we provide for weight loss assistance or support for people with diabetes? Again, this is one of the areas a constituent of mine has been denied on the basis that it would be offered locally. I’d like to know what area that that would be new for this coming year. Thank you.
First of all, weight management is part of diabetic response, but the weight management you’re probably referring to is the one connected to bariatric surgery, not necessarily diabetic. In fact, some diabetics have trouble with types of surgery. So I want to just separate what this is.
One of the ways that Alberta -- I’m familiar with this one -- managed some of their wait times to specialists around bariatric surgery and to also screen the appropriate clients was to introduce some weight management. These programs, by the way, are not medical, are not insured benefits, and they were provided on contract through places like the YMCA. We’ve been sending people to the YMCA for some weight management programs that we think can be offered in different ways. They are not diabetic treatment. They are for those people that may or may not be appropriate for bariatric surgery. Certainly, with obesity it’s around a prevention to diabetes.
So some of these issues were that, again, in looking at how the approvals were made, clinical approval, specialists from the South approving, and this has been now looked at. So we know that other jurisdictions have been able to manage these both through on-line programs, programs that could be delivered. Again, the example of using telehealth in small communities, and we think in other ways. So that’s what we’re exploring. But the issue is not diabetic treatment, and it’s not just an insured service. So that’s what we’re looking at as to how that will be managed here. Thank you.
