Debates of February 9, 2011 (day 36)

I’d like to call Committee of the Whole to order. What is the wish of committee? Mrs. Groenewegen.

Jane Groenewegen

Hay River South

Thank you, Mr. Chairman. The wish of the committee today is to continue with the Department of Health and Social Services and, time permitting, to begin with the general comments on the Department of Education, Culture and Employment. Thank you, Mr. Chairman.

Thank you, Mrs. Groenewegen. We will continue with Health and possibly move to Education today, but we will start with a brief break. Thank you.

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I’d like to call Committee of the Whole to order and we’re working on the Department of Health and Social Services. I’d like to ask the Minister if you will be having witnesses today. Minister.

Yes, please. Thank you, Mr. Chairman.

Thank you, Minister. I’ll ask the Sergeant-at-Arms to please escort the witnesses into the House. Committee agree?

Agreed.

Thank you, Sergeant. I’d like to ask the Minister to please introduce your witnesses.

Thank you, Mr. Chairman. I have Deputy Minister Paddy Meade and director of finance, Mr. Derek Elkin. Thank you.

Thank you, Minister. Welcome to the witnesses. Committee, we left off on page 8-29. Mr. Abernethy.

Thank you, Mr. Chairman. I seek unanimous consent to go back to page 8-25 for a short, quick question.

There has been a request to go back to page 8-25. Does committee agree?

Agreed.

Thank you, committee. Go ahead, Mr. Abernethy.

Thank you, Mr. Chairman. Yesterday in this session there was some talk about the extended health benefits and the Minister indicated that she was going to be bringing back their direction on that. I look forward to that, but there were also questions on how the department plans to provide support for what we once categorized as low-income families who didn’t receive insurance or any support for health benefits from their employer. Now I understand fully that that is gone. That policy was rescinded, but there are still employees out there who do not have health benefits or whatnot from their employer. I still think that we need to find a way to help those employees who do not have coverage from their employers. Many of them are low-income families.

When I look over the principles in the report from the working group, one of the things it talked about is companies must be encouraged or required to obtain private insurance and then there were recommendations that indicated that employers must be encouraged, both directly and through the structure of programs, to provide third-party insurance to employees. All members of Chambers of Commerce have access to its group insurance program, public sector employees. To that end, I thought the department was committed to trying to help these employees who didn’t have insurance obtain some sort of insurance. I thought that is how we were going to deal with those what we once categorized as low-income employers who do not have coverage. Can the Minister confirm that that is still one of the directions that this department is going to be taking to help fill that need of those individuals who don’t have any coverage today? Are we still trying to actively encourage or are we looking for a mechanism whereby we can actively encourage employers to provide insurance? Is that still something that is underway? Thank you, Mr. Chairman.

Thank you, Mr. Abernethy. Minister Lee.

Mr. Chairman, that option is there but what I was speaking about is the fact that we are not going to have strength of a policy change to do the things that we had wanted to do under the Supplementary Health Policy. It was a package under the policy and the policy has been rescinded. Encouraging or asking companies to provide insurance is one option, but without policy change or more weight behind it, it will remain an encouragement.

Yesterday much of the discussion was about more direct involvement and interventional role by this government. I was saying that to do that, it will need a new policy and the way we are going about it right now is to try to work as much as possible within the existing Extended Health Benefits Policy. Short answer to that is yes, but it wouldn’t be as strong as we would have been able to do with a policy change. Thank you.

Mr. Chairman, that is good to know. I am happy to hear that there is still some work being done on that. I understand that it will likely need policy change and, as a result of the decision to rescind, I know that you are not planning any policy change now. But this is obviously something that is important, and anything the department can be doing with its partners -- maybe ITI as an example -- to work with employers to find reasonable ways or reasonable mechanisms by which they can provide insurance to their workers where they don’t currently.

I know the chamber offers things and whatnot that are available. Anything we can do as a government to encourage our employers to help their employees so they can maintain health coverage, regardless of income level, I think is the right thing to do. I am encouraging the Minister to don’t let that one split by the wayside. Keep working on it. It might be the 17th Assembly where something has to come forward, but we sure would like to see something that helps those families who do not have any coverage at this point in time. I think it is in the best interest of the population. There is a good chance it could save us expenditures in the future. Healthier people tend not to use health care as often. That is all I have on that section, Mr. Chairman. Thank you.

Thank you, Mr. Abernethy. I will give the opportunity to the Minister to respond to that.

Thank you, Mr. Chairman. I generally agree with what the Member is saying. I think we will be able to have more discussion once we could make the proposal available to the House and the public. Thank you.

Thank you, Minister. Let me repeat this, then. We are on page 8-25, Health and Social Services, activity summary, supplementary health programs, operations expenditure summary, $26.218 million. Does committee agree?

Agreed.

Thank you, committee. We are returning to page 8-29. Mr. Abernethy.

Thank you, Mr. Chairman. This section covers, obviously, an area that is important to a number of us, community health programs, which also includes the Child and Family Services Act. I thank the Minister for providing us with the department’s or, rather, government’s response to the Child and Family Services Act in time that we could discuss it as we get to this section.

A lot of work was put into the review by committee and a lot of work was put into the responses by the department. Although we may have some differences of opinion on some of the wording within and we may not fully understand each other yet on what the recommendations and what the responses are, I look forward to an opportunity and I look forward to continuing to work together on that to find some real meaningful solutions and a real solid go-forward plan so we can benefit the children and families in the Northwest Territories.

However, there are some specific finance questions I would like to ask, things that are obviously timely and things that we or I and some committee members feel may have been missed in this business plan and these main estimates that we see in front of us. In the Child and Family Services Act, one area that is critical and makes our act unique in many, many ways is the establishment of the child and family service committees in the communities. During our journeys we heard many, many people talk about these committees. Some people were talking about them because they just learned about them for the first time ever when we mentioned that they exist; others didn’t know about it. But these are unique aspects of our act and it is something that we should be proud of. Unfortunately, we haven’t done a very good job of implementing these committees.

The Minister can correct me if I am wrong -- I may be -- but I could have sworn that there was some reference during previous discussions that the Minister made reference that the department was hoping to have five committees up and running during 2011-12. My question is around those committees. If you look at the response to the Child and Family Services Act, it actually said that it doesn’t make any reference to establishing any new committees at all. It says that you agree that these committees are important, but that there are significant financial implications associated with this recommendation. A detailed cost analysis will be included for consideration in future GNWT planning and full implementation will be dependent upon available resources, which worries me given how important this is. Could the Minister commit to ensuring that at least five child and family services committees are established in the Northwest Territories by the end of the 2011-12 fiscal year?

Thank you, Mr. Abernethy. Minister Lee.

Mr. Chairman, as the Member knows, that suggestion is one of a number of proposals that have been given to me that are under consideration. We are analyzing them and we will get back to members in committee on how and what options we have to make those happen. I am going to have to answer that in that way.

I do want to add a couple of things. The Member is right that the current legislation allows us to have children and family services committees. It is actually one of the pioneering and hallmark of this legislation that is different than many other legislations across the country. I was not aware, actually, as a Regular Member, that there was no funding that went with that. I think when we look at like committees, say there are other community justice committees, for example, I think there are budgets attached to that, but we’ve never had a budget attached to children and family service committees.

Regardless, the department has worked over the last couple of years to get these committees going. We’ve done it by contacting and communicating to community leadership, community governments, and it has been difficult. We have tried, it’s due to lack of capacity, but also we do need to have money to expense those to be able to consider paying per diems, or organizing money, setting up. So it will require some investments. So I take Member’s requests, I reiterate that it’s one of the things that the committee has asked me to look into and we are analyzing those and we will get back to the Member. Thank you.

For the record, you can hear all four of them today as well. When it comes to the child and family services committee, short sights from previous governments are hardly our problem. This is something that’s in the act, it’s something that should have always been there and we need to find a way to make it happen. There are options. Let’s think outside the box.

There are, as you pointed out, already existing committees in other departments. If there are opportunities to have the two departments work together for mutual benefit and provide these services, I think we should explore those options. I would expect the Department of Health to consider any and all opportunities to grade these committees and going out to the communities and listening to them and hearing how they would like to see these committees established is incredibly important.

Every community is different, every community is going to have a different concept and idea how this will work best for them. I think it’s important to find the money. These are the children, these are the families we’re talking about, this is a big deal. So I would like to hear some more commitment to move and be flexible on this.

The second one I have to ask you about is prevention and early intervention. Recommendation number 4, we asked the department to commit to the ‘11-12 budget money to move forward on adjuring funding for prevention and early intervention in every community, and the department, the government rejected this recommendation. We think this is incredibly unfortunate. Prevention is critical to improving the lives of children and families in the Northwest Territories and we would like to see some prevention and intervention in place.

The department travelled with us on our journeys. They knew that this was an issue. It shouldn’t have been a surprise. We also dropped the report in the Minister’s hands weeks before its official release. So they had opportunity and time to consider building something into the main estimates on this one. So I’m disappointed that there wasn’t an attempt. It may be unreasonable for us to expect that every community could have programs and money in place within a fiscal year, but there’s no reason we can’t see progress and movement in at least a number of communities. So my question to the Minister is: could she commit to ensure funding for prevention and early intervention in communities throughout the Northwest Territories in the ‘11-12 fiscal year?

As the Member indicated, this is one of the items that we discussed when we met with the committee and I am considering those and analysing them. Mr. Chairman, I agree with the Member that this is something that we need to work on and that’s the reason why, when I did my opening statement last Friday for this budget, I announced an extension of these programs to Early Childhood Intervention Program in Fort Simpson and Inuvik. So, obviously, the department has made that a priority and put it into the budget and within the opening statement.

The recommendation, how I read it, was that that should be made available in 31 communities, and that’s fine. We don’t have a problem with that in principle, which is what we said, it’s just that that has to come with dollars, and it has to come with significant dollars. The very rough estimate we could think of is at least $6 million. So it’s not something I can just do by moving the money around. I don’t have $6 million sitting around that hasn’t been spoken for, but I am encouraged by the committee’s interest in working together with me to see what options I can come up with. As I committed yesterday, I will get back to the committee about options available to us that we can consider together, not to do 31 within this budget, just to be clear, but to do anything that we can do. Thank you.

I’m happy to hear that. Thirty-one would obviously be our dream, but some progress in this is important and progress builds upon progress and hopefully eventually we’ll have all 31, but we definitely want to see some movement in this area.

Just for the record, the Minister did make reference to the Healthy Families Program. That was a completely separate recommendation and I’m happy to see that the Minister is moving on the recommendation.

One other area that we talked about when we were out in the communities was we clearly heard that people just were confused, frankly, just had no idea what their role under the Child and Family Service Act was, what their rights were under the Child and Family Services Act. Some plain language clarity on the act and their rights within the act would go a long way to improving implementation and the lives of children and families. So one of our recommendations was to develop a plain language policy and procedures document for public information, such as guidelines, how-to resources, a website and pamphlets for parents, families and children involved in the child protection system. This was recommendation number 34. We don’t see this as costing a significant amount of money, but we have significant benefits to the people of the Northwest Territories. Understanding goes a long way to streamlining the process and helping the families. We want to see progress in this area, in this recommendation in the 2011-12 fiscal year. Once again, we don’t see a significant amount of money, we are happy that you conditionally accepted it, but please include this in ‘11-12 with some dollars and start making progress on it for the sake of the children and for the sake of the families in the Northwest Territories. Thank you, Mr. Chair.

Thank you, Mr. Abernethy. Clarifying comments there. Anything further, Minister Lee?

Thank you, Mr. Chairman. We’ve discussed this and we commit that I am giving it full consideration and I will be communicating with the committee. Thank you.

Thank you, Minister. Next on my list I have Ms. Bisaro.

Thank you, Mr. Chair. I’d like to start by following up on the issue of child and family services committees further to Mr. Abernethy’s comments. In looking at the business plan that we reviewed in September, there’s a specific reference in the business plan to establishing child and family service committees in at least five more communities in this business year, and that was targeted for year ‘11-12. I’d like to know from the Minister what changed between September and the finalization of the department’s budget that she now says they will try to get five communities with child and family services committees. Thank you.

Thank you, Ms. Bisaro. Minister Lee.

Thank you, Mr. Chairman. As I stated, this has been in our work plan. It has been the objective of the department to set up more children and family services committees. This issue has come up before the CFSA recommendation and, as I stated to Member Abernethy, we have had difficulties setting that up. So the business plan said our goal is to have at least five.

Right now, and as the Members know, the only real possibility right now of setting up within this year is Fort McPherson, and that has been in the works for three years. It has been extremely difficult. It’s not just about the department going out and setting them out. We need the community support and community participation, we need the capacity building and such.

So I think what we need to do is we need to put in some financial resources and that’s the next level that we need to think about in light of the Standing Committee on Social Programs’ suggestion that we take a more interventionist role in that regard. It will take some money and we need to look at finding funds.

Thanks to the Minister. I totally understand that there are resources that are required. I guess I’m trying to understand why the business plan in September indicated that resources would be available in budget year 2011-2012 to establish five committees and now that money seems to have disappeared.

I also want to mention, and I believe it’s in the Child and Family Services Act review report, that one size does not fit all in terms of child and family service committees and we emphasized in the report that there needs to be flexibility in how these committees are established. In some communities there’s a very strong possibility that the child and family service committees could be part of the community justice committee that they could operate together and the same people could do two different jobs. That’s just one possibility. There’s any number of different avenues that communities can use to establish a committee which will assist them in child and family services and in apprehensions.

I wanted to speak a bit to funding for the Food First Foundation. It is something which has been funded, I think, by both the Department of Health and Social Services and Education, Culture and Employment over the last couple of years. I’d like to know if there is funding in the budget for 2011-2012 to assist the Food First Foundation with their programs.

Just on the first two points, the Member is right that we had as part of the business plan that we would like to have five children and family services committees set up, but that doesn’t necessarily mean that we will put resources or that dollars are attached to that. The business plan is a plan. It’s what we want to do as a department. There are dollars allocated but there are lots of other policy framework and directives that we lay out there.

The second thing is, yes, I agree with the Member that flexible approach is desired and that is what we have been doing. The director of our child and family services have travelled to many different communities meeting with the community people, community leadership, and working to set up the child and family service committees. While I appreciate the committee saying this is so important and why can’t you just get going, we need to have partnership with the communities. This can’t be just a top-down approach. I just want to reiterate that we will continue to work on that.

On the Food First Foundation, we don’t have any information here on whether we’ve given them money or not. I am aware that that organization has had funding assistance from some parts of this government, but I will have to take that question on notice and get back to the Member.

Thanks to the Minister for that commitment. I guess I would refer the Minister to a letter from the Executive Council that responded to a letter from Food First Foundation. You might ask the Minister of ECE for a copy because I think he signed it.

I wanted to also ask in terms of mental health and addictions. The information that we were given, again in the business plan in September, is that the department was doing a review of mental health and addictions programs. That review was going to be completed, I think, in November 2010. I’d like to ask first if that review is indeed completed, and if yes, can Members get a copy of that review?

Just firstly on the Food First Foundation, I have seen the letter from Mr. Lafferty. It was under the heading of Executive Council because it involves more than one department. That’s why I said it might be getting funding from somewhere, I just don’t know exactly which department. I’m going to get back to the Member, as I had already stated.

The Mental Health Program review began in November and we hope to have that finalized with recommendations to the standing committee in the spring, April-May.

Obviously things change over months. The business plan stated that the review had been completed, but there we are. I certainly look forward to the review when it’s done. I would hope that the review would come with some sort of an action plan at the time that we get it.

I wanted to also ask the Minister about the staffing for the Joe Greenland Centre. I know the purpose of that facility is changing. It will be seniors housing. Yes, I guess kind of home care assisted housing to a certain extent. There are any number of employees there who I gather will not be able to be employed. My question goes to the staff that will be required once the long-term care half of that building has been changed over to seniors housing or assisted housing, whichever it is. My understanding is, from what I’ve read in the plans, that there will be, I think, three home support workers required. I’ve anecdotally been advised that some of the people that are going to be hired for there are not home support workers but health workers that require far higher qualifications. A dietician I think is one name that was mentioned and I can’t remember the others. I’d like to ask the Minister if she can confirm what staffing is going to be required for the renovated section of Joe Greenland Centre. I gather there’s one home support worker there now. Will they be hiring two more home support workers and that’s it, or are they hiring home support workers and other types of health staff?

The program change at Joe Greenland Centre is to use the facility for what it was really meant to be. It was not designed for level III and IV care that we’ve delivered there for the last number of years. Since 2007 we’ve had very few residents there.

When this wing is renovated and converted into independent units, we don’t anticipate that we will have staff in that building. It will be like the other wing. There will be a caretaker and that sort of support.

What we anticipate is to expand the Elders Program for the entire community. Right now for the entire community of Aklavik there’s one home care worker. We anticipate that we could have up to three home care workers. We want to be able to run any elders day programming out of Joe Greenland Centre. We believe there are about 30 to 40 elders there in their homes who need support from home care workers with all sorts of things that home care support provides.

The question about whether this home care worker will require more skills, that’s not the information we have. We believe that those employees that are affected, HR rules require that we give them notice at the earliest possible opportunity when there are any contemplations of changes in jobs being considered. So that’s why they had to be given notice very early and they are all eligible to apply for not only these jobs but also any other jobs that come at the community as well as in the region or anywhere.

Thank you, Ms. Lee. Next on my list is Mr. Menicoche.

Kevin A. Menicoche

Nahendeh

Thank you very much, Mr. Chairman. Just with regard to the delivering of community health programs. As I travel to the communities in my riding, the communities have been requesting, I think the communities get a $5,000 allotment for developing their own community-based community health programming. One of the communities, I think it was Trout Lake, found out that for the amount of in-house programming that they wish to deliver, $5,000 they feel doesn’t really cover their needs. They’ve often asked me to forward that concern on to the Health Minister. I think I have on a couple of occasions in the past year, requesting to see if there can be more funding for community-based health care prevention services. They can bring in their own healers if they wish for their different unique needs in each community. They did find that $5,000 was... In a community like Trout Lake, it gets eaten up a lot by transportation costs. That’s a real consideration for that. I’d just like to ask the Minister what the reason is for the $5,000 limit. Is there opportunity for communities to access more programming dollars for their needs?

Thank you, Mr. Menicoche. Ms. Lee.