Agreed.
Page 8-9, information item, revenue summary. Any questions? Ms. Bisaro.
Thank you, Mr. Chair. I want to thank the Minister for the information on the THSSI funding which is about to expire and on the new funding which we are about to get but we don’t know what we’re going to use it for. I was going to ask what the department intended to use if for, but I can appreciate that without the detail. But I am somewhat confused.
Before I go there, if the Minister could provide committee with the information that he listed off about the numbers and so on that THSSI is used for. I don’t know if we have that or not, but it would be helpful if we had that listed, whatever he was reading from.
The Minister stated in his opening comments yesterday, I think I mentioned it in my general comments, as well, that $3.2 million will address a base deficiency in Stanton Territorial’s medical travel budget. I believe I heard the Minister say just now that this is one-time funding. I’d appreciate an explanation of the $3.2 million. He also said $5.2 million has been added to the budget to address the increased costs of children and adult placements outside of the NWT. So, on those two items, could I get an indication of whether or not they are both one-time funding? Thank you.
Thank you, Ms. Bisaro. Mr. Abernethy.
Thank you, Mr. Chair. The $3.2 million that’s in the budget for medical travel this year is the money I was talking about just a couple of minutes ago where we do have money for 2014-15, $3.2 million, but it’s not ongoing. Obviously we need to do some work there.
With respect to the $5.2 million that I mentioned for southern placement for adults and children, and that’s to go to different facilities in the South for programs and service that are available for our high needs residents here in the Northwest Territories, has been added to the base and it is ongoing funding. Every year we end up coming for significant supps to cover those costs and we’ll be coming at some point this fiscal year to cover those costs. We’re trying to address that in the future by putting that in the base.
Thanks to the Minister for clarifying that. I am very glad to hear that the money has been added to the base for outside placements. That’s something that has been needed for quite a long time.
My last question here on this revenue page is: When the details of the federal funding are known, would the Minister commit to share that information with committee and have a conversation with committee about how the federal money is being used?
We don’t have a lot of flexibility on the categories we will be able to spend those federal dollars in, but as we get more clarity around those categories that we can spend dollars and we have some concepts or ideas about where we might be able to utilize those dollars, I will absolutely have discussions with committee.
Thank you, Mr. Abernethy. Mr. Hawkins.
Thank you, Mr. Chairman. I actually have a question on 8-7. We blew by that page pretty fast. I’m thinking I could probably deal with my questions later on, but I just have some general questions. I’m happy to wait for Members to finish on 8-9.
Mr. Dolynny.
Thank you, Mr. Chair. I believe we are on 8-9. I want to formulate my questions regarding the reciprocal billing. I believe 8-9 is closely linked with 8-37 involving Non-Insured Health Benefits being paid back by the federal government. Now what we see here in terms of main estimates and revised estimates and what was in the past historically, I find it odd that we are seeing the same numbers repeat themselves. This amount we get in revenue, does it truly cover the full amount of Nunavut patients that come here for services and are we actually acquiring the full amount of those services with this revenue money? Thank you.
Thank you, Mr. Dolynny. Minister Abernethy.
Thank you, Mr. Chair. It’s an accountant type question, so what I’m going to do is go to Ms. Mathison to respond.
Thank you, Minister Abernethy. Ms. Mathison.
Thank you, Mr. Chair. We think that they cover everything for the Nunavut patients, but these are estimates as presented here.
Thank you. Mr. Dolynny.
Okay. So I guess to continue my questioning on here, there has to be some historical information with respect to the average billing that we’re doing on behalf of our Nunavut territory and money is coming in from Non-Insured Health Benefits. So I’ll formulate my question another way. Has there been a shortfall historically between what we’re actually billing out and what we’re receiving in in terms of revenue from the Non-Insured Health Benefits? Thank you.
Thank you, Mr. Dolynny. Minister Abernethy.
Thank you, Mr. Chair. The Non-Insured Health Benefits doesn’t appear on this page. It is on the page that the Member referred to previously. I think it’s page 8-37.
With respect to what we’re billing back from Nunavut, we do bill on actuals, but we have to project based on past experiences. If you look at the first column, 2012-13 actuals, those are the actuals. The main estimates for 2013-14 were based on estimates. The revised main estimates are showing the same number, but in the next main estimates you will see 2013-14 in this column and you will see the actuals because by then we will actually know what they are. We are building upon those numbers for the 2014-15 calculations based on what we know from past usage.
I believe – and the Minister might want to correct me if I’m wrong – page 8-37 is directly linked to this program line. The billing is going to Non-Insured Health Benefits, as far as I’m aware. I guess the question still stands. Have there been shortfalls? What have those shortfalls been with the billings that we’ve been doing with Nunavut patients versus what we’re getting in as revenue to cover those for those patients from Nunavut? Have there been historical shortfalls and are those shortfalls captured in these estimates? Thank you.
Thank you. The dollars you see on page 8-37 are for NIHB are not revenue. We’re not making money on that at all. We’re receiving the dollars and providing the service.
So on page 8-9, these are revenues. Where are these revenues coming from for the reciprocal billing for services for Nunavut patients? Thank you.
We provide services in the Northwest Territories for Nunavut residents and we charge Nunavut back for those services. Therefore, it is a revenue we are bringing in which is why it appears on this revenue page.
These are First Nations patients. These First Nations patients are entitled to Non-Insured Health Benefits, which is paid out by the Government of Canada through Non-Insured Health Benefits. So, whether or not we’re billing the territory of Nunavut, everything funnels back to our federal counterparts for the actual cheque. So, again, my question still stands. Have there been shortfalls and are those shortfalls embedded within the revenue summary on page 8-9? Thank you.
We provide services to residents from Nunavut here in the Northwest Territories. We charge Nunavut. The relationship between the residents of Nunavut and their government with respect to NIHB is done there. We don’t get involved in the discussions between Nunavut and the federal government. We have discussions with our residents who are covered by NIHB with the federal government. So a Nunavut resident comes in, whether they are NIHB or not NIHB, we provide services, we charge Nunavut, Nunavut then figures out their banking with respect to NIHB and the federal government. We’re not involved in their negotiations or discussions.
Okay, so let me ask the question another way. Is the Government of Nunavut current for all billings for their patient services here in the Northwest Territories, and has that been accounted for should there have been any historical shortfalls from year to year?
As of November 2013, there is about $2.54 million owed to the GNWT by Nunavut for health services. These receivables are clearly within acceptable time limits for payments, and accounts are considered up to date. We continue to receive dollars from them on a regular basis.
Per the GNWT public accounts as of March 31, 2012, there was about $9.7 million owed to the GNWT by Nunavut, so that shows that we do collect on a regular basis, based on the actual costs.
With that one number that the Minister just gave of over $9 million as arrears, that exceeds the actual full main estimate in relation to some of that billing line, so are we to assume that the numbers we have here for reciprocal billing are lower than what we normally do on a regular rolling average? Thank you, Mr. Chair.
Those numbers are provided as money owed from Nunavut to the GNWT for a variety of services, not all health related, to government as a whole.
Alright, so let me ask this question in another way here. Has the difference, the delta, any potential monies that we are billing out for patients, or basically patients are coming from Nunavut to the Northwest Territories to receive a CT scan, any type of diagnostic and we bill the territory of Nunavut for those services, are we capturing 100 percent at the end of the fiscal year for all of those billable services? Thank you, Mr. Chair.
Mr. Chair, the actual cost for all procedures is negotiated on an inter-jurisdictional reciprocal agreement. We believe right now that we are collecting all the dollars owed based on the formulas that we have agreed to.
I’m hearing that we believe, but accounting is about accuracy of dollars and cents. Does the department have and do they table this information? Is it readily available for committee to review? Thank you.
Mr. Chair, we have no indication that we haven’t collected all of our dollars, recognizing that the inter-jurisdictional reciprocal agreements are negotiated every year, but we do collect all the dollars based on what we are able to charge based on the agreements we have in place.
I believe that’s not the answer to the question. The question still stands. Will the Minister and department share this financial information with committee? Thank you.
The Member can correct me if I’ve misunderstood him. If the Member is asking us to share our inter-jurisdictional reciprocal billing agreements on how things are charged, no problem.
Mr. Chair, that’s not the answer to the question. I mean, if the Minister wants to share the terms of reference for the agreements, I’m happy to receive that, but the question still is asking about the aggregate accounting that we receive in terms of patient in-service billing and what we bill out for services. Would the Minister and department provide those numbers for review by committee? Thank you.
Once again the Member can correct me if I’m wrong; it sounds like he’s asking us to provide what we’ve billed and what we’ve received on a historic basis. I’d be happy to do so.
Without sounding like a broken record, I’ll ask again. Will the Minister agree to provide committee the full accounting of what is billed and what is received for the Government of Nunavut when it comes to medical billing? Thank you.
I’ll say it again, that’s pretty much exactly what I just said I was going to provide, what we billed and what we received. No problem. We’ll provide that.
I appreciate the Minister committing to that. If I can get that for the last three fiscal years. Thank you, Mr. Chair.
That’s fine. We can do that.
Thanks, Mr. Abernethy. Ms. Bisaro.
Thanks, Mr. Chair. I just have another question that arose on this page, listening to Mr. Dolynny’s back and forth. Where is the revenue from NIHB recorded on this page? Thank you.
Thank you, Ms. Bisaro. Minister Abernethy.
It’s not revenue, Mr. Chair. It’s on page 8-37 because it’s a third-party funding agreement.
Page 8-37 shows $11 million going out. I presume we get money from the feds. Where is that recorded? Thank you.
That is the net in and out.
So we are spending $11 million-something-or-other, $11.9 million over what the federal government funds us for. Is that correct?
Ms. Bisaro, you’re talking about a different page. I’m just wondering if I can keep the detail and questions to the revenue page that we’re on. Ms. Bisaro.
I can save them for later, Mr. Chair, but I’m trying to find the revenue and apparently there is none.
