Thank you, Mr. Chair. As I’ve mentioned several times, we are working and moving forward on this initiative. We are currently doing a number of back office functions. We’re working on shared procurement, shared IT/IS/IM, we’re looking at the territorial physician pool or the territorial physician model. A number of these things are well in progress and well on the way.
We have been having discussions with committee. We have been having discussions with our Aboriginal government partners, with the JLC, which is the Joint Leadership Committee, which is the chairs and public administrators of all the authorities, as well as the CEOs on how and what needs to be done to bring us into a territorial system that will meet the needs of our residents.
We will be going to communities and having discussions over the next fiscal year. We will be meeting with leadership across the territory over the next fiscal year and we will be figuring out and working closely with committee, as well, on the direction we will take. But many parts are well in progress for the back office and we will continue to move forward, with support of committee.
Thanks for the details there from the Minister and the duplication, apparently. Is there a target date in mind to complete this work?
I just want to add one piece that I forgot to mention, and it’s basically the Hospital Insurance and Health and Social Services Administration Act is going to be coming forward with a legislative proposal. That is being drafted now, so we will be coming to committee to have some discussions around that.
Many of the back office stuff is well underway and we hope to make significant progress in the IT/IS/IM sections with Stanton and a few of the other authorities bringing them into a central back office function this fiscal year. Procurement we intend to make progress on. There are a number of the other ones, and I can provide the committee with more detail in writing about where we are with some of these back office functions.
As far as the next steps, we want to make sure we get it right, and it’s going to involve lots of discussion with committee and with residents of the Northwest Territories. We don’t have a real defined timeline, but we would like to make as much progress as we can in the life of this government. We have committed to putting some structure back in those communities and those regions where there are public administrators within the life of this government. Those things are directly correlated and directly related so we’ve got a lot of work to do.
Thank you, Minister Abernethy. Moving on with questions on this page 8-17, I have Mr. Moses.
Thank you, Mr. Chair. Just a quick comment but then I do have one question in particular. The Minister did release this document Measuring Success, the annual report for NWT Health and Social Services. It has a lot of good stats in it, and it just kind of goes to show when we do put money into prevention, promotion and education that we do get results from our territorial statistics.
Specifically I want to talk to something that came out of this report. In priority 3 it mentions that the number of clients receiving home care in their home community is at 2,071. That’s 168 more than in 2011-2012, and if you average that out to each community in the Northwest Territories, it’s about 62 clients in each community.
My first question is: Does the Minister know how many home care workers we have in the communities and whether or not each community does, in fact, have home care?
Thank you, Mr. Moses. Minister Abernethy.
I’d like to thank the Member for the question. Home care is an incredibly important service that we provide in the Northwest Territories through our individual authorities, and we anticipate the demand on home care services is going to grow as we have an aging population and we’re supporting them to age in place.
The Member has averaged out the demand based on a by-community total, which may not be a fair way of splitting or rationalizing how many home support workers are in each community because every community is different, every community has got a different aging population and different people with different needs. I can tell you that we have, by authority, 29.03 positions in Yellowknife Health and Social Services Authority, home support workers, and that includes home support workers, home care nurses and other positions. I’m going to break it down and that should make it a little easier.
In Yellowknife Health and Social Services, we have 6.5 home support workers, we have homemakers rehab aides, we have registered nurses, so home care nurses, 5.6, and then there are some other related types of positions, rehab aides and whatnot. In Fort Smith we have 1.5 home care nurses, 1.5 home care LPNs, 2.75 support workers, and a medical social worker as well. In the Tlicho we have a lot: 12.5 home support workers, home care nurses, related type positions.
There is a lot of detail. It might be better if I just provide the Member with a written breakdown because it’s going to take a long time to go through. If the Member is alright with that, that’s what I’ll commit to do.
I know the importance of home care in the community and I know I did break it down on average just to see what it was in places like Yellowknife and some of the smaller communities that have a lot of our elderly senior citizens who don’t want to leave home and want to live that independent lifestyle in their community. Those are where we see some of the higher per capita numbers, and I just want to make sure that we do have the services to support them.
Moving forward, I know I had some questions in the House, and it brought me on to seniors, which also deals with home care, but when I was looking at some of the policies and procedures under Seniors Action Plan, since it’s dealing under the territorial health services, the action plan hasn’t been updated. I’m not sure if there has been a report since 2003 on the action plan. A lot has changed since then. That’s been about 11 years. I just wanted to know if the Minister has any indication of when we’ll have a renewed action plan or if we’re going to get a report on some of the things that were outlined in the action plan. As we are getting into a higher senior population, I just want to make sure that’s addressed and we’re taking care of that moving forward and not trying to catch up after the fact.
Thank you, Mr. Moses. Minister Abernethy, the audio did not pick it up, but I think the Member did want a copy of those statistics you offered earlier. Minister Abernethy.
Thank you, Mr. Chair, and we will certainly provide that.
The strategy that the Member is talking about is an old strategy, and moving forward we are going to be coming forward with a new strategy. It’s going to be informed by the continuing care report that was released just a couple of days ago to Members. That’s going to help inform the direction we take. We will be coming forward with an Aging in Place Strategy. We’re hoping to have that done by March 31st of this year, so that we can share it with committee. That will help inform how we move forward to deal with the aging population, the number of the individuals that need different levels of support and what types of things we’re going to need to do over the coming years to help people age in place as much as possible. It won’t be just about staying in homes. It will be about the full continuum from staying at home for as long as you can and is reasonable to moving into maybe independent or assisted living and then to more of a long-term care and extended care into dementia, if necessary. We will be coming forward to have those discussions with committee.
At the same time, I would like to say that in partnership with different departments we have updated the Seniors’ Handbook, which identifies different programs and services available to seniors and elders in the Northwest Territories. That’s been updated as recently as 2012.
Thank you, Minister Abernethy. Committee, we are on activity summary 8-17, Health and Social Services, activity summary, program delivery support, operations expenditure summary, $46.490 million. Does committee agree?
Agreed.
Thank you, committee. Page 8-18 and 8-19 are together. Activity summary, program delivery support, grants and contributions, $24.416 million. Does committee agree?
Agreed.
Thank you. Page 8-20, information item, program delivery support, active positions. Any questions?
Agreed.
Seeing none, 8-23, activity summary, health services programs, operations expenditure summary, $209.007 million. Does committee agree? Ms. Bisaro.
Thank you, Mr. Chair. A couple of questions here. There is a large increase in grants and contributions and a fairly large increase in fees and payments. Could I get an explanation of what those increases are for, from, to, et cetera?
Thank you, Ms. Bisaro. Mr. Abernethy.
Hold on one second.
Page 8-23. Minister Abernethy.
Thank you, Mr. Chair. With respect to grants and contributions, there have been about six-ish million dollars in increases. I can just walk through some of those. We’ve had some Collective Agreement increases for both the authorities, including Hay River. That’s about $1.9-plus million. We’ve got some initiatives we are working on that are priorities of the Legislature, which is the Midwifery Program expansion, that’s $470,000. We have the Northern Alberta Renal Program, a much smaller amount, $1,000 it looks like in direct program delivery. This is the one-time funding that we’ve talked about to replace the THSSI funding. An allocation of $1.6 million for Healthy Pregnancies, $180,000 there. We’ve got some forced growth as well, contracts with the NWT Med Association for family practitioners. It’s about $789,000. Some additional forced growth around dietary, laundry, housekeeping contract with Stanton, $93,000. Some northern allowance increases, $112,000; Economic Evergreen Plan for program vehicles, $405,000; release of costs of essential services, $306,000; professional fees, $119,000; supplies, $104,000; chemotherapy drugs have gone up $132,000; and then callback and stand-by pay, $1 million.
Thank you, Minister Abernethy. Ms. Bisaro.
Thanks for all that detail, maybe a bit too much. I’m trying to understand. This is an increase to grants and contributions and fees and payments. A lot of the ones you mentioned were increases in what sounds like compensation. Are these contributions to health authorities? Is that why they’re under grants and contributions and fees and payments? Thank you.
Yes, these are grants and contributions going to the health authorities. Then under fees and payments, insured services for non-NWT residents went up $4 million.
That’s good. Thank you.
Thank you. Page 8-23, activity summary, Mr. Bromley.
Thank you, Mr. Chair. A little follow-up here. For this one-time funding, I believe we are responsible, then, for coming up with our own dollars for these services subsequently. What is the plan for that? Obviously the planning would have to take place during 2014-15 if it disappears at the end of that year. Thank you.
Thank you, Mr. Bromley. Minister Abernethy.
Thank you, Mr. Chair. A number of these items were covered in the THSSI funding that I described yesterday. We’ve put it in 2014-15 and the Department of Finance has agreed to cover these on a one-time basis. The original plan with the THSSI funding, we were always supposed to have an exit strategy. That exit strategy was never fully developed and/or implemented. If we had cut many of these programs that are in place now without having some sort of transition plan, we would have adversely affected these services going to all NWT residents. So we were able to put money in for this year and we have to come up with some sort of plan to move forward on those for upcoming fiscal years.
I believe the THSSI money is not necessarily meant to cover these things. They will be starting again in one form or another. Has THSSI been approved at some point?
We’re not sure what the federal government is going to call this $70 million, but THSSI, as we know it, no longer exists. They have given us some broad statements that we were able to get out of their budget statement about what these dollars are intended for, but it doesn’t seem to directly correlate to things THSSI funding in the past. It may, some of it might, but at this point in time we’re not 100 percent sure. When we know and we’re in a position to pursue those dollars, we will certainly be having discussions with committee. I can say they have been very clear up front that no money will flow unless there’s a clear strategy. These dollars are not intended to be put into ongoing programming, but are designed to give us the dollars we need to build a system that will meet needs. So it’s more short-term funding. It’s not permanent funding in any capacity.
I know some of that was repetitious. I hadn’t got the full picture on that before. Again, there’s nothing new here. The Minister said himself we were to plan this out of our base levels in the past. We failed in every instance. The Minister says we’ve got the same expectations again, but I haven’t heard anything that tells me how we’re going to do that or that we are. It sounds like we’re just going to ignore it again. We’re obviously not thinking about it. I’m looking for something that says, federal government, we’re hearing you. We’ll do the work and this is how we’re going to do it, or we’re going to hang our hat again on the hopes that new money will come forward. We need to know that. What model are we doing here?
The Member is correct. We need to make sure we have a plan that includes an exit strategy and that we use these dollars to help improve the system and put structures in place that will control things that the federal government will require. As I said, in the budget address by the federal government, they identified the $7 million over three years for new targeted and time-limited fund to increase health services in the three territories in priority health areas and to reduce reliance on outside health care systems and medical travel. These are the parameters. We will get more detail and as we get more detail, we will sit down with the Finance Minister to figure out how we put in a plan and what programs we move forward with that will meet the targets that they have recognizing that anything we do cannot become part of the base.
It is time limited with the purpose of improving our services in the long term. We need to have a plan, otherwise they won’t give us the money. We need to make sure there’s an exit strategy or they won’t give us the money. I’m confident that we can do this.
This THSSI funding seemed to drag out from the THAF days to the THSSI days and they always said you need an exit strategy. A lot of work was done, but as far as having a comprehensive exit strategy to get away from those dollars, it wasn’t done to the degree that maybe would have been appropriate.
I think it would be great if these dollars continued to come, obviously, but in the meantime it makes me very nervous. We’ve been through this before. We were all in the panic when it happened in the 16th because we are using this temporary money for basic service delivery. I think we have made some progress. I’m hoping midwifery, for example, is no longer in that one-off funding.
I will leave it at that. I don’t need any more information right now, but perhaps the Minister can recommit, if he hasn’t already, to work with committee on this as soon as he has information. I would think committee could play a role in contributing towards decision-making on this. Thank you.
I have already committed to doing that and I agree with what the Member says, we clearly need to have a plan.
Committee, we’re on page 8-23, activity summary, health services programs, operations expenditure summary, $209.007 million. Mr. Bromley.
Sorry, just one more question. As Stanton gets more and more cooped up and people are stumbling on each other and working out of closet space and so on, are we finding that we’re using other facilities more? Are people being sent south more and so on? How are we staying on top of the impacts and trying to mitigate this situation at Stanton Territorial? Thank you.
Thank you, Mr. Bromley. Minister Abernethy.
Thank you, Mr. Chair. We do prefer to keep our residents in the Northwest Territories and we do have a territorial bed management program that helps us, where possible, keep our residents here in the Northwest Territories. We continue to use services in the South – MRIs, other things – and where load is there, we will send our residents south for programming, but we do our best to keep everybody in the North as much as possible. We don’t offer every service that’s offered in the South, so from time to time our residents do have to go down.
Really the point is here that we only hear about the challenges and kerfuffles when we visit the hospital as committee. I think it would be useful to hear from the Minister some objective assessment of this situation so that we can help him make sure that situation is managed. I’ll leave it at that. Thank you.
Thank you, Mr. Bromley. I’ll take that as a comment. Page 8-23, activity summary, health services programs, operations expenditure summary, $209.007 million. Does committee agree?
Agreed.
Thank you, committee. Page 8-24, activity summary, health services programs, grants and contributions, $158.361 million. Does committee agree?
Agreed.
Thank you. Page 8-27, activity summary, supplementary health programs, operations expenditure summary, $27.3 million. Ms. Bisaro.
Thanks, Mr. Chair. I just have one question here. During the 16th I know the Minister was well aware and the deputy minister, as well, well aware that we had a protracted investigation into supplementary health benefits and potentially looking at charging residents a certain amount to access our supplementary health programs.
I’ve certainly heard from some of my constituents, maybe not a lot of them, but I’ve certainly heard from constituents that it’s time that we start not means testing necessarily but charging a small fee for the extra services that we provide as a government.
I’d like to know whether or not the department has any kind of work that they’re doing, or perhaps work that they are considering doing in the future, to look at either charging a service fee for access to services and even pharmaceuticals and/or means testing. Thank you.
Thank you, Ms. Bisaro. Minister Abernethy.
Thank you, Mr. Chair. This was certainly a big issue in the 16th Assembly and it’s something that needs to be done. What I have committed to is we will do work on this, but we need to complete a few of our other priorities and make some human resource room to actually conduct the work. If everything is being done on the side of a desk, nothing gets done, and there is a significant amount of good work that we’re doing in the department to improve services to our residents. This does need to be done, but it’s a lower priority for us at this time. But we will continue to research and gather data so that when we’re ready we can make informed decisions on moving forward.
Thanks to the Minister. I can appreciate that you can’t do everything. I would like to know where it’s at. In terms of a time frame, is it something that you’ll get to before the end of the 17th Assembly or not? Thank you.
