Thank you, Mr. Chairman. The current facility was constructed in 1983 and does not meet the current needs of the community and of the region. This is going to be a level B facility being constructed there and should be roughly double the size of the current building. So essentially what is planned is the long-term care facility in Fort Simpson is still a building that is useable, still very functional and still meets the needs of the long-term care in Fort Simpson and the area that uses it. So that part of the building will remain and the new health centre without the long-term care will be constructed. The plan is it will be constructed across the road. Thank you.
Thank you very much. Certainly I’m glad for that level of detail and I’d like to be involved, perhaps, in Fort Simpson. Maybe the Minister and staff can advise of when they’re going to do planning studies or engage the community. I’d certainly like to be part of it to ensure that we have something the community wants. Thank you very much.
Thank you, Mr. Menicoche. I’ll treat that as a comment, I guess, unless the Minister wants to reply. Minister Beaulieu.
Thank you, Mr. Chairman. We can provide the Member with a schedule on the planning study and then as we get into the schedule, indicate in the schedule at which point we will do the consultation with the community.
Thank you, Minister Beaulieu. General comments. Mr. Bromley.
Thank you, Mr. Chair. Welcome to the Minister and staff here. I wanted to ask about, in a general sense, the long-term sense, assisted-living facilities, extended-care facilities across the Northwest Territories, and I believe it was the projections of the Avens Seniors’ Society that estimated an equal or greater than tripling of seniors needing care in the next 15 years. I’m wondering: Is that consistent with the Minister’s knowledge, and further to that, just to get the questions in here, what is our strategy for addressing the need, whatever the Minister’s estimate of it is, and are we on track to achieve that?
Thank you, Mr. Bromley. Minister Beaulieu.
Thank you, Mr. Chairman. There are various numbers that do come out. They are all fairly consistent. We have numbers from a national perspective. We have numbers from the territorial perspective from Avens. We ourselves at Health and Social Services are currently doing a long-term care assessment. I don’t remember exactly when we’re scheduled to finish that. Maybe I’ll have Mr. Elkin just give you a time when we’re anticipating that work to be completed.
Thank you, Minister Beaulieu. Mr. Elkin.
Thank you. Over the last month we’ve had a consultant engaged to renew our long-term care needs assessment, our whole continuum of care, and we should have the results of that internally within the department within the next few weeks and then we’ll consult with stakeholders after that.
Thank you, Mr. Elkin. Mr. Bromley.
Okay. Thank you. So that’s on the numbers. In terms of what the strategy is to meet those, obviously, we need to be starting yesterday on that, and I see in the budget today we’re making some significant progress. I know that there are partners out there like Avens who are critical partners and provide leadership, but certainly not every community has that capacity. I’m just wondering: In terms of where are we at on putting a strategy in place to address that need, given that we know it’s going to be some big number, do we have that strategy yet and where are we at in its implementation? Thank you.
Thank you, Mr. Bromley. Minister Beaulieu.
In my role as the senior administrator responsible for seniors, we do a lot of work at the national level, called Aging in Place. The NWT Health and Social Services has a continuum of care for seniors. That, essentially, is our strategy. We look at the long-term care based on age, and then we determine the percentage of individuals that would require long-term care. Then we develop a plan that tries to prevent seniors from going into long-term care as a first priority, so that we are holding back trying to provide seniors, whether they be in homeownership units, public housing, or in senior citizens homes, which again is another form of public housing, we would try to hold them back from going into long-term care as long as possible. From that plan, we will have a better idea as the numbers roll out, how many people of that certain age group that we are looking at will actually end up in long-term care. I believe that currently at a national level about a little over 20 percent of individuals actually end up needing long-term care, so it’s not everyone that needs long-term care. We have to work with that realistic number when we plan future infrastructure for long-term care.
Thanks to the Minister for that information. Could I get the Minister to commit to bringing forward a strategy for meeting those needs over the long term – and specifically I’m talking about infrastructure needs – to committee once he’s got the numbers in a few weeks and has the opportunity to develop such a plan?
I will commit to providing the information that we get from our study. I can’t quite understand the note here, so maybe I’ll have Mr. Heath add to what I’m committing to now.
Thank you, Minister Beaulieu. Mr. Heath.
The infrastructure needs are typically addressed through our capital planning process. The Department of Health and Social Services has been working diligently for quite a long time in preparing their 20-year needs assessment and the long-term care needs will be addressed through the capital planning process.
Thank you, Mr. Heath. Mr. Bromley.
That’s great, so I guess I can expect that the Minister will be bringing that forward to committee. When might we expect that strategy for dealing with this long-term care issue, as we know the numbers are increasing rapidly?
Thank you, Mr. Bromley. Minister Beaulieu.
Once we have the data and recognizing that, we’re bringing some long-term care facilities on-line. At this point there are an additional 10 units in Behchoko, 18 units in Norman Wells, an additional 10 units in Hay River that are currently in the plan. We’re looking at, like I said, other ways of preventing individuals from needing those facilities. Once we have the numbers, not waiting for the units to be completed, but once we have the number I can bring it forward. I don’t think it would take a long time to do that. I hate to commit people when I don’t have the information, but I would say that it would… In a couple months we can probably have all of the details on what our long-term needs for long-term care would be.
Could we likely add the ongoing work with the Avens Seniors as a possible facility that we could put on the books at some point soon with that?
We’ve met with the Avens Society. They have a good plan. The plan is something that is intended to address all of the needs in the Northwest Territories as a fairly elaborate facility that is designed to support people that have long-term care needs and also dementia. Yes, we will continue to work with Avens. They’re the experts in long-term care and we’ll continue to work with them and we will engage them throughout the process.
My last comment is fairly specific. We’ve had, this fiscal year, an increase of about 60 to 70 percent from our main estimates to current estimates in our large capital, and about a 700 percent increase in our information technology, a smaller total amount, but maybe could I just get a brief explanation of what those are about, those increases?
We’re moving into the better technology to assist us in health care. We’re going to have electronic medical records right across the entire system. We’re moving all of the authorities into TSC so we’ll have one system that will all be compatible with each other and it will be linked together and working together as a unit, so that’s takes some upfront cost.
For the capital, the simple answer is that we are involved in a lot of construction. There is construction of a fairly modern health care centre that’s 1,000 square metres larger than the current H.H. Williams Hospital. We have a fairly large long-term care facility in Behchoko. We are currently starting construction in Fort Providence for a new health centre to replace the health centre. Our infrastructure budget has gone up accordingly, of course, as we move up the queue with health projects and it takes some money to get those on the ground, but those essential pieces of infrastructure. Thank you.
Thank you, Mr. Beaulieu. We are moving on with general comments. I have Mr. Nadli.
Thank you, Mr. Chair. Certainly this department is one of two departments that have the biggest budgets within the GNWT system. At this point there are several projects that have been undertaken. One of them that figures prominently is in Fort Providence, the health centre. I understand that there is a lot of activity in terms of building a foundation and I think that’s on track.
The other area of interest is the Judith Fabian Wellness Centre that was recently opened. I would like to at least have the Minister explain just how it is that that model was reached, because as I understand it, there is a labyrinth or multi-faceted jurisdictions in terms of an Indian reserve under the federal system that is within the GNWT. I wanted to see if perhaps that has set precedence for maybe the further advancement of programs and services for the K’atlodeeche First Nation and the reserve.
The other point that I wanted to also touch on is just in terms of the small communities in terms of bringing health care services to them and ensuring that they have access to nurses and access to home care. At least in one of the small communities that I represent, they have expressed an interest in terms of trying to at least bring a level of service to the community. They have been in transition of trying to establish a facility for visiting nurses or practitioners that come into the community to be able to have at least an office of some kind for either treatment or diagnosis.
The other point that I wanted to touch on, of course, is the Nats’ejee K’eh Treatment Centre. I know it’s a fact that it’s closed. I know the other thing that is hinged on that is in terms of development of the on-the-land program. I am certainly interested in terms of what the features of the program are and how it will figure prominently within the health care system in terms of addressing the very fundamental challenges of alcohol and drugs and the problems that we all have in the NWT. Those are just some key points, if I can have the Minister comment on and clarify at least those points. Mahsi.
Thank you, Mr. Nadli. Some of those questions were program- and operation-based. I will leave it to the Minister to respond accordingly. Minister Beaulieu.
Thank you, Mr. Chairman. The wellness centre on the Hay River Reserve is definitely under Deh Cho Health and Social Services. However, the actual medical services to the Hay River Reserve have been provided by Hay River Health and Social Services Authority. We have to sort that out on that building.
I had a discussion with the head nurse out of Fort Providence, as she was asked by Deh Cho Health and Social Services to come to the opening of the wellness centre and to see what files were there that she could take, so that as they begin to man the wellness centre on the Hay River Reserve, they would be up to speed on the files. She discovered that there are no files on the Hay River Reserve. The medical files are all in Hay River. What we had talked about was that the Hay River Reserve would get its medical services from Hay River. That is currently the plan. We have run into some issues with the consultation or the development of the plan on how we’re going to provide medical services to Deh Cho communities that were in close proximity to Hay River, including Fort Providence, Kakisa and Hay River Reserve. That specific facility would most likely be housed by individuals out of the Hay River Health and Social Services Authority.
We recognize that, in the short conversation I had with the chief of Fort Simpson and also the MLAs, the communities of Fort Providence and Fort Simpson still consider Yellowknife to be their support when they need some medical. So that is the stuff that we’re sorting out. But specific to the wellness centre on the Hay River Reserve, it makes good sense to man that wellness centre out of the Hay River Health and Social Services Authority.
In Kakisa we have rented some space from the band. We are going to bring a nurse most likely out of Fort Providence into Kakisa and then the appointments will be made there. They are setting up. I think they bought some things; I’m not sure. These gentlemen were involved with that portion of it, but there are certainly things I talked to the chief there and they were pleased that they are able to have a contract to have a sort of clinic in there, a day clinic in Kakisa on some band property.
All of the people in Enterprise get their medical services from Hay River Health and Social Services Authority.
Regarding Nats’ejee K’eh, I don’t mind answering questions. We have not developed the on-the-land program as of yet. We have hired an individual that is going to work exclusively on developing an on-the-land program in consultation with communities. I believe that they may have had their first joint meeting in Fort Simpson last week…or earlier this week, pardon me. What we are doing is developing a youth element. That was one of the other recommendations from the Minister’s Forum on Addictions and Community Wellness, that we also develop a youth addictions program. This individual is working with developing an on-the-land program for youth and that’s the first piece of the puzzle. We don’t have any of the documentation from the development of that program at this point.
Mr. Chair, I have one final question. I want to seek clarification in terms of just perhaps a decommissioning of the old health centre. I know there has been an expressed interest from various groups within the community in terms of the fate of the old building that has serviced the community since the 1960s, I believe. I know the department will play a role in determining if there will be a function for the old health centre. Has there been perhaps a process in terms of how the community could continue to be engaged and perhaps help out in the decision on the infrastructure that will remain after the new health centre is built?
We have been in contact with the two Aboriginal organizations in the community, or governments I should say – the local Metis group and the Fort Providence Zhahti Koe Dene Band. So both requests were for them to use the building. One request was to use the building for long-term care and putting four or five individuals in there instead of them moving to Hay River or Fort Simpson long-term care. They would like to keep their elders in the community as long as possible and turn that into a long-term care.
The second request was for the building to become a wellness centre, so they would run all their drug and alcohol programs out of that facility. What we do know at this point is it does have to go through the disposition process with Public Works and we have done an evaluation on that building. The one item that is going to be very costly for individuals that may take over that building could be the roof. There are major issues with the roof of the old health centre in Fort Providence. That’s something we are going to have discussions on with local organizations. If they want to deal with Public Works on a disposition, we will most likely be releasing that building once the new health centre is in operation. Thank you.
Thank you, Mr. Beaulieu. Mr. Nadli, your time is up. You can ask other questions in detail. Moving on with general comments, I have Ms. Bisaro.
Thank you, Mr. Chair. I just have a comment and a couple of questions. It’s been said before by a number of Members, but I have to say it again, since we are now in the Health and Social Services department, and that is the lack of focus on the renewal project for the Stanton Hospital.
I know that there’s money in this budget, but it’s not going to lead to any significant construction in the near future. I want to reiterate again how important it is that this government find a way to finance this project and that we do it sooner rather than later.
I’m following with interest the back and forth on the long-term care and needs of the territory. I am in full support of the work that Avens is doing. I have been privy to a briefing on their plan. I think it’s a great plan and I’m a little surprised that the department is now going out and doing the same work that Avens had done. It seems to be a waste of our resources. The numbers from the Avens report are pretty evident and I think the research is sound, so I’m not sure why we are doing the same research over again.
I didn’t hear from the Minister when he expects he would be able to get the research they’re doing on the long-term care planning and if he did give a date, then my apologies. Could I know roughly within a month or so when you expect the long-term care planning study will be done? Thank you.
Thank you, Ms. Bisaro. Minister Beaulieu.
Thank you, Mr. Chairman. On the long-term care, we aren’t planning on discounting the work that Avens had done. Avens had presented the work to us. We’ve looked at it. I think we’re going to do some more studying on the information and do some of our own grafting on aging population. Like I indicated in my response to a previous Member, the numbers that we’re getting… The number at a national level and the numbers provided by Avens are fairly consistent. It’s just a matter of us checking the numbers to make sure we file our own information on that. I would say that wouldn’t be a huge job, aside from the volume of work at Health and Social Services. I would say that within a couple of months we should be able to have that information. I should be more specific; within two months we should have that information.
As far as Stanton goes, we’re moving through the process. The plan is to renew Stanton. The schedule is we will improve and renew Stanton and as we move through the process and at the end of the day, we’re building, we are renewing or renovating and the hospital can take us 20 or 30 years. So the hospital can address our needs 30 years into the future. Stanton needs a lot of work and it’s very technical work. We’re going to keep the hospital open, obviously, during the time we are going to be working on Stanton, so it’s not like new construction. We can’t be constructing in certain areas, so we have to do it in phases and move people around. This all takes time. Once the renewal has started, once construction has started we’re expecting that the construction phase is going to be five or six years.
I’m not quite sure where to start here. With the long-term care, in two months’ time, once you have done your work, you have looked at the work from Avens and you make sure they jive, so to speak. What is the intention? What is the department going to do with the numbers you get in two months’ time? Avens has put out that we need 600-some beds for long-term beds over the next I don’t remember how many years. When the department has numbers that say basically the same thing, what is the intention of the department with regard to long-term care facilities? Thank you.
I don’t want to be pulling numbers out of the air here. I recognize that the project is going to be around $30 million. That’s what I know. How many beds that constitutes, I don’t think it’s 600 but I know it’s a project that they see as something that would take them, again, into the future. The reality is they are trying to build something that will take them to 2035, approximately. So the next step, if we agree this is what we need, this is the cost of what we need, is to put it through the capital planning process so that long-term care facility, Aven Centre, can be put up against all of the other needs that we have across the territory. The process that we are going through here today will be the same process that we will go through when we review Avens.
I’m still a bit confused. I appreciate the Minister is talking about the Avens project, but I got the impression the planning study the department is doing is bigger than that. It’s looking at the whole territory. If the department is going to support the Avens project and not any other projects within other communities, that’s fine by me because I know how badly Avens needs to expand, not just for Yellowknife but for other communities as well.
I want to return to the Stanton issue and I thank the Minister for the information, but I know the plans for this project. My concern is the financing for the project and the Minister didn’t touch on that at all. If we look at the numbers that we have been presented with, the number that is in this budget is not going to take us very far at all and even over the next three or four years the numbers that are projected are minimal.
So my question to the Minister was that I am exhorting you to get the financing, construction financing in place, and I appreciate that construction is going to take five or six years, but we may not start for 10 years because we don’t get the financing and that’s my concern. We need construction money not in 10 years’ time but in two or three years’ time. So I’d like to just leave that.
I do have a question with regard to the numbers that are on page 6-2. The large capital projects in this fiscal year, for the fiscal year 2013-14, the main estimates were for about $34.7 million. The revised estimates are for $58.5 million. So they’ve gone up some $24 million or so. I know the Minister talked about a number of projects that are ongoing and we’ve got large capital projects happening, we’re building health centres and so on, but what happens between the main estimates for this fiscal year and the revised estimates? What $25 million did we put into this capital budget? Thank you.
Perhaps we have new detail. I’ll have one of the staff, Mr. Elkin, respond to the change.
Thank you, Minister Beaulieu, Minister Elkin.
Thank you. The increase between the main estimates and the revised 2013-14 represents the capital carry-over for the projects that were in progress. It’s the timing of the payment to construction that happens every year. So the budget we had in ‘12-13, it was unexpended and got carried over to ‘13-14.
Thank you, Mr. Elkin. Ms. Bisaro, last opportunity. Go ahead.
That’s great. Thanks, Mr. Chair.
Thank you, Ms. Bisaro. General comments. Is committee prepared to go into detail?
Agreed.
Detail it is. Committee, we’re going to defer 6-2. I’d like to turn your attention to 6-4, Health and Social Services, activity summary, health services programs, infrastructure investment summary, infrastructure investments, $58.426 million. Does committee agree?
Agreed.
Thank you, committee. Page 6-7, Health and Social Services, activity summary, community programs, infrastructure investment summary, infrastructure investments, $3.462 million. Does committee agree?
Agreed.
