Thank you, Mr. Speaker. I would like to recognize John Sabourin, Eli Nasogaluak, and Derrald Taylor. They are three world-class artists from my riding of Kam Lake who work at Frozen Rock Studio. Thank you very much for being here today.
Masi. Recognition of visitors in the gallery. Member for Tu Nedhe-Wiilideh.
Marsi cho. Mr. Speaker, I would like to recognize the two interpreters we have from Tu Nedhe-Wiilideh, Mr. Tommy Unka and Mary Rose Sundberg. I would also like to recognize my new CA, Pascal Erasmus, who is in the gallery today. Thank you.
Masi. Recognition of visitors in the gallery. Member for Yellowknife North.
Thank you, Mr. Speaker. Mr. Speaker, I would like to recognize Yellowknife North constituent Cathie Bolstad, also executive director of NWT Tourism. Welcome and thank you for being here.
Masi. Recognition of visitors in the gallery. Member for Sahtu.
Mahsi, Mr. Speaker. I, too, would like to recognize Yvonne with the original, I have to get used to the new last name, Nakimayak. Sorry about that. With family ties back in the Norman Wells Sahtu area, and Ms. Cathie Bolstad, who I've met over the years here promoting a thriving industry. Mahsi.
Thank you, Mr. Speaker. Mr. Speaker, I would like to follow up on my Member's statement with some questions for the Minister of Health and Social Services. My first question for the Minister: does the department track how many patients from the Nahendeh riding missed appointments or have to reschedule appointments because of flight changes? Thank you, Mr. Speaker.
Masi. Minister of Health and Social Services.
Thank you, Mr. Speaker. Mr. Speaker, our responsibility is to provide healthcare to the residents of the Northwest Territories. Yes, many residents do have to travel to Yellowknife or other locations to receive their care. Through medical travel, we book our flights on scheduled flights. We work with our residents to make sure that they know the information. The Member is right. From time to time, there are cancellations of flights. We do live in the Northwest Territories, where we do have adverse weather and other things that affect us.
We don't track the cancelled flights, Mr. Speaker, but we work with our residents to make sure that, if there is a cancellation, we get them on the next appropriate or available flight. If appointments have to be cancelled, then we work with them to reschedule those appointments and make them happen as quickly as we can. At the end of the day, Mr. Speaker, we know we live in the Northwest Territories. We know there are challenges and we work to resolve those problems. Thank you.
I thank the Minister for his answer. I realize we live in the Northwest Territories, but, again, if a contractor is not providing the services, we need to make sure we do deal with that. Has the department approached the contractor or have they approached the Department of Infrastructure to help get this situation fixed?
As much as I'd like to be able to control the weather, we can't. When there are flights cancelled as a result of weather, we work with our residents to make sure that those appointments are rescheduled and the flights rescheduled appropriately. The Member has brought that concern from his region to me. I share his frustration on the number of cancellations that occurred.
Following up on our discussions, the department did follow up with one of our main contractors from Medical Travel, who does the majority of the flights in the Nahendeh region. They indicated to us that it has been a particularly harsh winter. As a result, they have had to either reschedule or cancel a number of their flights.
Once again, our priority is to making sure our residents get the care they need and they're getting the appointments. We work with our residents. Yes, sometimes that means that appointments have to be cancelled, but we work with them to reschedule them as quickly as possible and to get them on flights as quickly as possible. It's not as always as smooth as we'd like, but we're committed to providing that service to our residents.
I thank the Minister for his answer. I guess I disagree. If it's not weather, I can guarantee you it was a beautiful day on New Year's Day and it wasn't the weather. Again, that is an issue.
I'm going to move on to something else in regard to my Member's statement. It is my understanding that there is close to zero vacancies of hotels and boarding beds in Yellowknife during various moments in the year. What does the department plan on doing to help alleviate this type of situation where patients have to wait at the airport due to no fault of their own?
I understand that some of the issues, according to the Member, might have been something other than weather, but I would like to point out that the beautiful Northwest Territories is 1.1 million square kilometres of land and 33 communities ranging from the Beaufort Delta to Fort Smith, including Yellowknife. I've been in Yellowknife on one of the most beautiful days and talked my friend up in Inuvik who had 40 below weather, blizzard, and no flights for landing. It is possible to have good weather in one location and bad weather in another location.
With respect to the Member's question, we do have some boarding room capacity. There are certainly only a certain number of beds in that thing. We also know that, with the increased demands around tourism, which we all know is a great thing, it does make it a little bit more difficult to get rooms. When we know we can't get rooms, we will work with our residents for non-emergency issues and try to schedule them for when we can get capacity. I strongly encourage residents to keep following up with medical travel and make sure we are having that conversation so that we can get them in as quickly as we can. We work with our residents.
The issue about where do people stay during a day trip, that is an issue that has been brought up by many Members, the Members from Sahtu, Hay River, and others. We are currently working on a review of medical travel, and we are hoping to find a way to resolve that particular issue. I am hoping to bring the medical travel review to committee by the end of March so that we can have a discussion on these types of issues.
Masi. Oral questions. Member for Nahendeh.
Thank you, Mr. Speaker. I am going to have to rebut that. I have been in the Northwest Territories all my life. Yes, it is 1.3 million great square kilometres, 33 communities. The day I am talking about, the plane went from Edmonton to Fort Simpson to Inuvik to Yellowknife. It hit four communities. Again, this airline company or the contractor didn't provide the service that was much needed.
I realize sending patient escorts out earlier than required might not be the best solution. I have heard it before about the potential appointments being cancelled, capacity issues with boarding homes, et cetera. I can't argue with those points. What is the department going to do to help patients who seem to be continually put out by this type of situation? Thank you, Mr. Speaker.
I hear the Member. We do know that there is some frustration with individuals who are uncomfortable with going the day of their appointments just in case there is a cancellation. There is some frustration there. Patients can go early. They can book the flights themselves and seek reimbursement. The reimbursement is based on the rate that we would pay. We have a standing offer agreement with a number of our airlines, which is a little cheaper than what residents would pay if they booked themselves. We can reimburse them up to that rate.
If there are unique situations, the residents can approach Medical Travel to see if there is an option for them to come early. We are open to those in unique situations on a case-by-case basis. There are a couple of options that are available for our residents. Thank you, Mr. Speaker.
Masi. Oral questions. Member for Nahendeh. I was just being generous. Member for Yellowknife Centre.
Mahsi, Mr. Speaker. Mr. Speaker, my questions are for the Minister of Health and Social Services. As I said in my statement, the caseload for the Public Guardian is completely unmanageable because of the number of public and private guardianship orders she needs to supervise. My question for the Minister is: when does the Minister plan to increase the number of staff who work directly with clients? Mahsi.
Masi. Minister of Health and Social Services.
Thank you, Mr. Speaker. Mr. Speaker, the Member did bring this to my attention early in the life of this Assembly. As a result, I did order a review to be done. There were 16 recommendations that came out of that review. Many of them required us to do things like providing some additional training supports. It did talk about increasing the staff. One of the things we wanted to do before we actually moved forward with a request for additional financial resources is to make sure we are spending our money wisely.
We have developed new procedures manuals. We have developed different training available to our people. We have gone out and recruited some psychiatrists and psychologists who can help us with specialized capacity assessments. Those things are done. We are strengthening the office. We are building a business case so we can move forward through the next round of business planning to seek funds to provide the financial resources we need for that unit. I feel that, now that this work is done, we are in a good place to build that business case to seek support. Thank you, Mr. Speaker.
I did give the Minister credit for speeding up the assessment process, but we are talking now about another year-long delay before this 150-person caseload is going to be addressed by more staff. That is entirely unacceptable. This office needs to be re-staffed now. I would like to see this staffing adjustment made in a supplementary appropriation during this sitting. Can the Minister make that commitment?
The Member is aware that we have processes that we utilize in this Assembly, including business planning, and that we have to have solid business cases if we are going to pursue or ask the Department of Finance and the FMB for additional resources. Currently, until we build that particular case, we are utilizing existing resources from the Department of Health and Social Services. We have identified staff to go and help the office meet their demand and provide work they are doing. All of this is helping us build a business case. We will be submitting the business case during the business planning process. Hopefully, we will see an expansion in that office.
It is my understanding that the additional staff relieve the Public Guardian when she is unavailable because of training or annual leave. It is not my understanding that there is any more than one social worker working in that office at any given time. Can the Minister please confirm that?
We are providing additional resources by way of human resources to assist that staff person when they are away on training and other things so that we don't fall behind further. The number of active files has decreased over the years. We are making improvements. The assessments are done by different individuals, psychiatrists and psychologists who we have contracted with. That has really helped us bring down the number. Those relationships will continue.
We will continue to bring our case file down. We will continue to provide the services. We are building the business case. We are going to put forward a submission once we have all the evidence we need to justify that, recognizing that all business cases have to compete against everything else in the Government of the Northwest Territories, we need to make sure we do the work right so we have that solid case.
Masi. Oral questions. Member for Yellowknife Centre.
Thank you, Mr. Speaker. Mr. Speaker, we are talking about the most vulnerable people in our society. They have intellectual disabilities. They have dementia. They have FAS and its effects. They need to have a relationship with the Public Guardian so that she can make effective decisions on their behalf. There are 77 public guardianship orders in place now. That means there is no family backup. There is nobody else to assist these people in making important decisions about their day-to-day life, and their health in particular. I can't understand why the Minister is not out in front of this and providing the additional staff immediately. My question is: will he reconsider? Mahsi.
The Member did bring this to my attention, and I directed the department to do the work. They did the work. We are rewriting the policies and procedures manuals, fixing the unit itself so that it can get best value for money and so that the staff are adequately resourced to provide the services that they want. There are 79 public guardianships. There are 85 private guardianships. There is a caseload of new applications.
We are working on these, trying to reduce those numbers to provide the support we need to the residents. I am confident that we are building the case we need to seek additional resources. In the meantime, we will fund within and provide the support centre needed to make sure that work is getting done. Thank you, Mr. Speaker.
Masi. Oral questions. Member for Mackenzie Delta.
Thank you, Mr. Speaker. Mr. Speaker, in follow-up to my Member's statement, I have a few questions for the Minister of Justice. Would the Minister of Justice please advise this House what process was used to determine which communities the GNWT visited on consulting on the proposed cannabis legislation? Thank you, Mr. Speaker.
Masi. Minister of Justice.
Thank you, Mr. Speaker. Legalization of cannabis was, of course, announced by the federal government approximately one year ago, so we had a very limited time to meet the target date of July 2018. Staff visited nine communities; Fort Simpson, Fort Liard, Inuvik, Tsiigehtchic, Norman Wells, Yellowknife, Fort Smith, Hay River, and Behchoko. We simply didn't have the opportunity or time to visit all 33 communities.
In addition to that, there was an online survey that was open to all residents. As I mentioned, public hearings were held in seven regional centres, including Inuvik, and two smaller communities, including Tsiigehtchic, which has a liquor prohibition regime in place, and Fort Liard. The meetings were well publicized. In addition to the meetings, of course, there was the online survey so that the opinions of residents could be obtained. Thank you, Mr. Speaker.
The Minister already answered my next question, so I'll go to my third: does the GNWT have any guidelines to assist the departments to undertake consultations?
Yes, of course, this government is committed to establish open government policy. In these circumstances, again, with the limited timelines that we had, we decided to visit a cross-section of the communities. With respect to Fort McPherson specifically I know that letters were sent to Indigenous and committee governments, including the Hamlet of Fort McPherson, the Tetl'it Gwich'in council band, and the NWT Association of Communities. In addition to that, there was a teleconference in which the people of Fort McPherson participated. Also, there was the NWTAC meeting a couple of weeks ago where officials and Cabinet Ministers attended. We are working currently to establish and develop public engagement guidelines so that we will have a policy in dealing with matters such as this.
Masi. Oral questions. Member for Frame Lake.
Merci, Monsieur le President. I would like the Minister of Health and Social Services to give us the current state of affairs on development and implementation of midwifery services on a regional and territorial basis. Given that the latest on midwifery does not present a solid path or timeline towards a Northwest Territories midwifery program, what concrete steps are being taken by the Minister to implement midwifery across the Northwest Territories? Mahsi, Mr. Speaker.
Masi. Minister of Health and Social Services.
Thank you, Mr. Speaker. Mr. Speaker, the Government of the Northwest Territories and the Department of Health and Social Services are still supportive of midwifery services. It is a mandate item of the Government of the Northwest Territories. The report was completed with 16 recommendations. We agree with all 16 recommendations. We are now moving forward with the program design. We're moving forward on the recommendations that were made. We're looking to develop a territorial midwifery program that meets the needs of residents throughout the Northwest Territories. This will include building and strengthening the existing two community-based midwifery programs, but also working with other providers such as community health nurses and others to roll out midwifery.
We're hoping to be ready to roll out midwifery services in the last year of this Assembly. It will go through the normal business processes and be discussed with committee as we begin that official roll-out. Thank you, Mr. Speaker.
I would like to thank the Minister for his response. He sort of answered my next question. I believe he said that he was starting to put together the proposal for a territorial midwifery program. Is that something that he can share with the standing committee, and when would he be in a position to do that?
We actually have hired a midwifery consultant and we are working with the different midwives in the Northwest Territories to help strengthen the existing services, but our territorial consultants are also working with us to update our procedures and our guidelines to make sure that they're current and they make sense. Those are building upon the recommendations.
I'm happy to have a meeting with committee if committee so desires to walk through where we are and where we're going and where we hope to be by the end of this Assembly.
Once again, I would like to thank the Minister for that commitment. I look forward to sitting in on that briefing. A number of training standards certification issues have been identified in past reports on midwifery. Can the Minister tell me what steps are being taken now and with what partners to ensure training and administrative oversight needs are in place to launch the programming once it is funded?
As I've already indicated, there was a report done. There were 16 recommendations. We've supported all 16 recommendations and we're moving forward.
The expanded program will allow for a continuity of maternity care and enable greater clinical support for residents of the Northwest Territories. One of the things that's being done right now is the NWT Midwifery Framework. It has been revised and we're entering the final stages of that approval. That includes the work that we're doing on guidelines to make sure that the guidelines are current and that they stay current. Many of these things will evolve over time as new science and new technology comes forward, but we're working on those guidelines now.
We have brought in the consultant, as I said, who is doing a significant amount of work on future design. As I said, I'm happy to meet with committee. I would suggest maybe after session would probably be best, to give us a little bit more time to get through the next couple of weeks. I'm happy to meet with committee to walk through where we're going, where we are, and where we hope to be in the life of this Assembly.
Masi. Oral questions. Member for Frame Lake.
Merci, Monsieur le President. Again, I want to thank the Minister for that. I'm sure that he will think about or would probably be able to give that briefing to committee in public, as I know there are a lot of interested folks across the Northwest Territories that would be curious to hear him make that presentation.
The Minister has spoken in the past about how we do have a bit of a complicated health system here with the NWT Health and Social Services Agency. There's the Tlicho Community Services Agency, Hay River Health and Social Services Authority. How has the Minister starting to work with these other agencies that are responsible for delivery of programs across the Northwest Territories in the hope of designing and implementing a program on midwifery? Mahsi, Mr. Speaker.
Ultimately we see them being a part of the single system here. We do recognize that there are some unique realities in our healthcare system with two separate boards. We hope to bring Hay River into the public service at some point. Until that happens, there is a midwife representative from the Hay River Health and Social Services Authority on the territorial midwifery expansion working group. They are participating in a design and participating in the work that is needed to be done before we could actually roll out a midwifery program.
We've also been engaging with the TCSA on the midwifery program expansion. We're planning to do more of that in the coming weeks and in the coming months. It's a little different, obviously, because of the structure that did exist with the TCSA, but they've been very open to working with us on being a part of a single system in the Northwest Territories. We expect they'll have some issues they want to address. We'll certainly work with them to address the issues that they raise. Thank you, Mr. Speaker.
