Mr. Speaker, on part of the hike, we have rules of conduct when hiking out on the trail. One of the things we thought would be good as part of the recommendations would be to put up some signs at mile 25 on Carcajou River or Twitya or Little Keele to let people know to respect the trail. They are entering into Sahtu Dene/Metis lands and to respect the Canol Heritage Trail. That’s part of the rules of conduct we have amongst our young hikers. Don’t throw garbage on the ground, take what you need to take out of there, be respectful of the area.
Is that something the Minister could look at? Maybe putting up some billboard signs for hikers as a reminder when they come onto the Sahtu lands?
Signage, of course, is important. Again, it would be in the department’s best interest to talk to the Member, talk to the people who have travelled the trail to find out where the best locations are for signage. I thank the Member for his offer and I’ll ensure the staff in the region get a chance to sit down with those who hike the trail and talk about where we can put the signage. We’ve had some capital dollars last year and we have more capital dollars earmarked for the area this coming year, so we may be able to look at some signage for the park. Thank you.
Thank you, Mr. Ramsay. The honourable Member for Mackenzie Delta, Mr. Blake.
Thank you, Mr. Speaker. At the beginning of session, I asked questions of the Minister of Transportation with regard to Highway No. 8. I know we don’t have funds available in this current budget to address the upgrades to the highway. I know one of the things that I was told is we’re waiting on a response from the federal government with regard to the Building Canada Fund. Since then, we’ve received confirmation, so I’d like to ask the Minister if there will be funding available to continue upgrades to the Dempster Highway, or Highway No. 8. Thank you, Mr. Speaker.
Thank you, Mr. Blake. The honourable Minister of Transportation, Mr. Beaulieu.
Mahsi cho, Mr. Speaker. Recently, we’ve received confirmation for the Building Canada Fund. We’ve had discussions internally about the allocation between DOT and Municipal and Community Affairs and funding the communities. So we have had most of those discussions. Right now, we’ve taken the money that was promised to us through the Building Canada Fund and we are now going to be discussing that to determine how we’re going to be able to match that money with the GNWT dollars in order to leverage the full amount that’s available. Thank you.
Does that mean we will have work for the highway this summer? I know a lot of people depend on that work. We employ over 40 people during the summer. Will that be in place for this current summer? Thank you, Mr. Speaker.
The plan moving forward and the portion of the plan that we had submitted to the federal government that was approved was for the reconstruction of most of the highway infrastructure across the territory. The Dempster is in there. As soon as we’re able to match the dollars, if we’re able to find matching dollars for the Dempster in 2014-15, then we will be starting year one of the Building Canada Plan work on the Dempster and other highways this year. Thank you.
That sounds promising, so I will have further questions during the spring session. Thank you, Mr. Speaker.
Thank you, Mr. Blake. Mr. Hawkins.
Thank you, Mr. Speaker. Recently, I’ve been informed that an applicant to the Growing Forward Program had received some money, but they used it for holidays and to take people away.
I’d like to ask the Minister of ITI, when we give money to applicants in programs like this, how often are they screened and evaluated in a follow-up process to make sure this doesn’t happen on a regular basis? Thank you.
Thank you, Mr. Hawkins. The honourable Minister of Industry, Tourism and Investment, Mr. Ramsay.
Thank you, Mr. Speaker. I’m not familiar with the suggestion that somebody was using program dollars for a vacation. If the Member wants to give me some details, I’m certainly more than happy to look into that. Thank you.
Thank you. I’ll certainly make sure the Minister receives those particular details, but one of the problems that I’ve seen with the Growing Forward Program is that the department doesn’t do a follow-up evaluation and certainly sort of a measured context as opposed to reporting back to find out how the money was spent and how it was enabled to do more as it always promised.
What type of screening, evaluation monitoring and management of the information and certainly the investment of the money is done by ITI and how is that distributed back to the public? Thank you.
Thank you. On an annual basis we table the grants and contributions report detailing the program dollars that we do get out there. Program dollars are delivered on a regional basis and we’ve got lots of examples of how that money is being put to good use here in the Northwest Territories. We’re developing an agricultural industry here in the NWT, we signed a new agreement with the federal government last year and we’re moving forward in a very positive manner. We’re also going to be developing an agricultural strategy and a firm, solid policy base for agriculture here in the NWT. I certainly look forward to the Member and other Members’ input into the development of that strategy. Thank you.
Thank you. Well, we all know where the money is going because it’s found in a report, that report is tabled, it’s available at the library or on-line. That’s all great information, but is there any follow-up compendium to know how the money was spent and what were the results achieved out of that type of money, because that would have all been part of the application to say I need X amount of dollars and this is what I plan to do with them.
Do we know if they actually did the stuff that they’ve applied for and met the spirit and intent of the application? Thank you.
Thank you. We do have professional staff across the Northwest Territories that does follow-up with folks that access dollars through those programs. If the Member has a specific concern over a specific application, or funding that went somewhere and wasn’t followed up on, again, I’d be more than happy to sit down with the Member or hear his concerns about a specific application and we can follow that up. Thank you.
Thank you, Mr. Ramsay. Time for oral questions has expired. Oh, sorry, Mr. Hawkins, final, short supplementary.
Thank you, Mr. Speaker. I appreciate your generosity there. The Minister says that people follow up, I can provide examples where people don’t follow up on grants and contributions given to individuals where they’ve applied to the department. All I want to know, and I think the public deserves to know right now, is where is this all reported? It’s great we know we can go to, say, group X or business X or NGO X and they got so much money, but we want to know to make sure that they did spend the money as they said they would. So we just need to make sure that that’s the case. That’s the issue right now. We want to see where it’s publicly reported, not just because the Minister says he knows. I want to see it reported. Thank you.
Thank you. Again, we table, on an annual basis, the grants and contributions report. Again, if the Member has any specific concerns, please bring them to my attention and we will follow them up. Thank you.
Thank you, Mr. Ramsay. Time for oral questions has expired. Item 8, written questions. Item 9, returns to written questions. Item 10, replies to opening address. Item 11, petitions. Item 12, reports of standing and special committees. Item 13, reports of committees on the review of bills. Mr. Moses.
Thank you, Mr. Speaker. I wish to report to the Assembly that the Standing Committee on Social Programs has reviewed Bill 4, Health Information Act, and wishes to report that Bill 4 as amended and reprinted is ready for consideration in Committee of the Whole. Thank you, Mr. Speaker.
Thank you, Mr. Moses. Mr. Moses.
Thank you, Mr. Speaker. I move, seconded by the honourable Member for Range Lake, that Bill 4, Health Information Act, be moved into Committee of the Whole for consideration today. Thank you.
Thank you, Mr. Moses. The motion is in order. To the motion.
Question.
Question has been called. Motion is carried.
---Carried.
Bill 4 is moved into Committee of the Whole for consideration today. Mr. Moses.
Thank you, Mr. Speaker. I seek unanimous consent to return to item 12 on the Order Paper, reports of standing and special committees.
----Unanimous consent granted
Item 12, reports of standing and special committees, Mr. Moses.
Thank you, Mr. Speaker. Your Standing Committee on Social Programs is pleased to provide the Report on the Review of Bill 4, Health Information Act, and commends it to the House.
Bill 4, Health Information Act, is the product of extensive work undertaken over the better part of a decade to develop health-specific privacy legislation for the Northwest Territories. The Standing Committee on Social Programs commends the Minister of Health and Social Services for developing the bill. With its passing, the Northwest Territories will join a growing number of Canadian jurisdictions that have enacted legislation of this kind.
Bill 4 was referred to the committee on November 7, 2013. The public hearing was held on February 20, 2014. Numerous stakeholders and citizens provided written submissions and made oral presentations. The clause-by-clause review was held on March 10, 2014.
It is the considered view of the committee that the act strikes an appropriate balance between the rights of patients and the need for efficiency within the system. At the same time, a great deal is riding on proper implementation.
The committee proposed and adopted two amendments during the clause-by-clause review of the bill, with the concurrence of the Minister. Both amendments are discussed in this report.
Mr. Speaker, I would like to now return the report over to my colleague, Mr. Dolynny.
Thank you, Mr. Moses. Mr. Dolynny.
Thank you, Mr. Speaker, and thank you, Mr. Moses.
Through an amendment, the purpose statement was broadened to address the rights of patients to access, correct and protect their personal health information. The committee reasoned that patient rights should be treated on a par with the need for system efficiency. A comparison of purpose statements in other health-specific privacy legislation lent support to this view.
Stakeholders stated repeatedly that the act is difficult to understand. Unease about its complexity was widely expressed. Following the public review, the committee identified this as an impediment to the provision of meaningful input and requested plain language material. The department obliged, providing a “Frequently Asked Questions” document and an annotated version of the act. The committee in turn circulated the material to the stakeholders concerned. The department posted the FAQ document on the website, taking a strong first step toward informing the public about this legislation.
Given the complexity of the act and its inevitable future impact, extensive public education will be required to make the legislation understandable. Extensive training will also be required to ensure that key players in the health sector implement the legislation in a consistent and accurate manner. To this end, the committee urges the department to widely circulate plain language material, including annotated versions of the act and the regulations. Real-life scenarios and vivid illustrations should be used to explain key terms such as “health information custodian,” “implied” and “express” consent, and the “circle of care.”
In line with health-specific privacy legislation in other Canadian jurisdictions, “implied consent” is the backbone of this legislation. It does not require written authorization and occurs during the routine course of a patient visit. The act places the onus on health information custodians to inform patients about implied consent and what it entails. The act further states that consent must not be obtained through coercion or deception.
The act gives patients the right to withhold and withdraw consent and to set limits on how their personal health information is shared. It is the patient’s responsibility to exercise these rights. During implementation, patients should be given repeated opportunities to absorb this information.
Special efforts must be taken to ensure that unilingual Aboriginal language speakers understand their rights and what this legislation means.
The department has allocated $462,000 in 2014-2015 for implementation. To ensure delivery of a comprehensive public awareness campaign and thorough training for custodians and health care providers, the committee urges the department to allocate approximately double this amount.
Several citizens raised concerns about the extent to which personal health information is shared with the “circle of care.” Patients should be able to obtain a log of everyone who has viewed their personal health information. This message should be clearly communicated to the public.
Concerns were expressed about what happens to personal health information when it leaves our borders. Through information-sharing agreements with Alberta, our most frequent partner in the provision of health care, and other jurisdictions, the department should ensure that personal health information is protected to the greatest extent possible when shared with health providers outside the NWT.
“Express consent” is a formal method of giving consent which typically requires written authorization. This method is used for some research purposes and when health care providers collaborate with other professionals such as teachers and social workers. Information about express consent should be communicated to the public and to helping professionals.
Mindful of the government’s goal of promoting service integration and interdepartmental collaboration, the committee is concerned that this legislation may entrench “service silos.” Reasonable measures should be taken to ensure that mental health workers, nurses and other health care providers are not unduly prevented from collaborating with teachers and social workers. Interaction between health professionals, child welfare agencies and schools is often more influenced by institutional culture than privacy legislation. For this reason, training for health workers should include a module on how express consent works in “wrap-around” and integrated case management settings.
Concerns were raised about researchers accessing patient information without their knowledge. Under the act, this can only be prevented if a patient makes an express statement to this effect. Once again, this message should be clearly communicated to patients and the public.
The Health Information Act and its regulations, taken together, constitute one of the largest information-sharing endeavours in the history of the Northwest Territories. Numerous details will be worked out in the regulations and while this affords greater flexibility to adjust legislation as required, the public has no opportunity to review them. Numerous stakeholders requested that such a courtesy be extended. The committee strongly echoes this request.
Security procedures will be laid out in regulations to protect against hacking, viruses and other security breaches. The serious breach of personal health information in Alberta recently illustrates the need to proceed with extreme caution. The regulations should establish meticulous and thorough procedures based on best practices nationally and internationally.
With respect to fees, the committee urges the department to continue the well-established practice of waiving fees under the Access to Information and Protection of Privacy Act, ATIPP. To discourage repeated, frivolous or unreasonably large requests, the regulations should stipulate that a fee can only be charged if the cost of processing the request exceeds a pre-set amount.
The committee was alerted to dangers associated with stripping, encoding or transforming information to create non-identifying data. Such dangers are amplified in a population the size of the Northwest Territories and they are not trivial. The committee urges the department to ensure that custodians are trained in de-identification techniques, including measures to reduce the risks of re-identification.
An amendment was made to the bill requiring the Minister of Health and Social Services to conduct a review of the act within 10 years of its enactment. This will allow legislators to test the department’s performance against its own rules.
At this time I would like to turn it over to the chair of the Standing Committee on Social Programs, Mr. Moses.
Thank you, Mr. Dolynny. Mr. Moses.
Thank you, Mr. Speaker. Thank you, Mr. Dolynny.
The Standing Committee on Social Programs strongly urges the following courses of action:
1)
that the Department of Health and Social Services develop and implement a comprehensive public awareness campaign;
2)
that the Department of Health and Social Services provide extensive training for health information custodians and health care providers;
3)
that the Department of Health and Social Services ensure the quality of patient care is not unduly compromised when a patient withholds, withdraws or places limits on consent;
4)
that the Department of Health and Social Services employ a grace period during the first year of implementation, requiring custodians to provide patients with repeated opportunities to absorb the legislation;
5)
that the Information and Privacy Commissioner be provided with additional fiscal and human resources to support implementation of the act;
6)
that the Department of Health and Social Services ensure consistent application of the legislation across all regional authorities;
7)
that the Department of Health and Social Services take reasonable measures to ensure that unilingual Aboriginal language speakers understand their rights and what the legislation means;
8)
that the Department of Health and Social Services provide an opportunity for the Standing Committee on Social Programs to review and comment on the regulations before they come into force;
9)
that the Department of Health and Social Services provide an opportunity for the public to review and comment on the regulations before they come into force;
10)
that the Department of Health and Social Services review the “Pan-Canadian De-Identification Guidelines for Personal Health Information” as prepared by the Office of the Privacy Commission of Canada and ensure the regulations include measures to mitigate against the risks of re-identification;
11)
that the Department of Health and Social Services clearly inform residents about their right to withhold consent to use of their information for research purposes;
12)
that the Department of Health and Social Services provide training to members of the territorial research ethics committee which conforms to the tri-council policy statement: Ethical Conduct for Research Involving Humans;
13)
that the Department of Health and Social Services establish information-sharing agreements with Alberta and other jurisdictions to ensure personal health information is protected to the greatest extent possible when it leaves the NWT;
14)
that the Department of Health and Social Services and other custodians make it their practice to comply with access and correction requests promptly and without undue delay;
15)
that the Department of Health and Social Services inform patients about their right to obtain a log indicating which individuals have accessed their personal health information;
16)
that the Department of Health and Social Services take reasonable measures to ensure the Electronic Medical Records System is running smoothly prior to implementation;
17)
that the Department of Health and Social Services ensure that mental health workers, nurses and other health care providers are not unduly prevented from collaborating with teachers, social workers and other professionals; and
18)
that the Department of Health and Social Services include a module in their training to custodians and health-sector workers on the “wrap-around,” or team-based, approach, including how to obtain express consent from clients.
The committee is grateful to everyone who provided input on Bill 4 and attended the public hearings.
The Standing Committee on Social Programs advises that it supports Bill 4 as amended and presented to Committee of the Whole.
Thank you, Mr. Moses. The motion is in order. To the motion.
Question.
Question has been called. The motion is carried.
---Carried
Thank you, Mr. Speaker. I wish to table the following document, entitled “NWT Anti-Poverty Roundtable Final Report, November 28-29, 2013, Detah, Northwest Territories.”
Thank you, Mr. Speaker. I give notice that on Thursday, March 13, 2014, I will move the following motion. I move, seconded by the honourable Member for Thebacha, that, notwithstanding Rule 4, when this House adjourns on March 13, 2014, it shall be adjourned until Wednesday May 28, 2014; and further, that any time prior to May 28, 2014, if the Speaker is satisfied, after consultation with the Executive Council and Members of the Legislative Assembly, that the public interest requires that the House should meet at an earlier time during the adjournment, the Speaker may give notice and thereupon the House shall meet at the time stated in such notice and shall transact its business as it has been duly adjourned to that time.
