Thank you. Minister.
Thank you, Mr. Chair. Mr. Chair, this is as a base adjustment to the budget, so you won't see these dollars showing up in future years. The role of the recruitment of physicians is also going to be part of the territorial health authority, so you probably won't see it specifically. We are comfortable right now with the changes we have made and the improvements we have seen that we will be able to control our spending in this area a little bit better than we have in the past, and we do not feel we need this $900,000 at this point. Should things radically change, we will certainly be prepared to have a discussion at this point, but we are trying really hard to be a little more creative here. We have approached U of A about some residency options here in the Northwest Territories as well as some outreach work that the medical students at U of A could do to get into small communities which is consistent with some of the recommendations in the TRC report. We are trying to create exposure and awareness of the North to potential practitioners. We are hoping that will result in more stability, even more stability than we are seeing over the last couple of years. It is a work in progress. I think it will always ebb and flow, but I think we are in a good place now with a single medical system. Thank you.
Thank you, Mr. O'Reilly.
Thanks, Mr. Chair. Yes, that is helpful to know. This is the predicted savings. I guess I am just trying to figure out next year, a year from now, business plans in the fall. I will ask then: how did the prediction work out? Is that something the department intends to sort of report on somehow in the business plan for next year, where we are at and how we are doing with the anticipated reduced use of locums? I am just wondering where that is going to be reported and tracked, or do I just have to ask at the next business plan? Thanks, Mr. Chair.
Thank you. Minister.
Thank you, Mr. Chair. Given that the role of hiring and tracking physicians is going to be a part of the territorial authority, they will be the ones that will be compiling that information. I will certainly, through the deputy, have a conversation with the CEO to make sure that is the type of data we are monitoring and so we can see how we are doing.
I will caution the Member: don't expect to see radical changes in year one or two. We have already recognized some improvements. In order to get real trending data on this, give us a few years to get some trending data. We can give you year to year, but I am not sure that is really going to tell you what you want to know. Trending data will give us better results over time. Thank you, Mr. Chair.
Thank you, Minister. Mr. O'Reilly.
Thanks, Mr. Chair. I believe in transformation, as well, but I have a line item in a budget now that says you are going to reduce the expenditures by $900,000. If FNB doesn't come after you, I will ask the same question next year. Fair enough.
I want to move on to tobacco cessation. I know this is the general area to talk about it. One of the most effective ways to reduce tobacco use is to increase the cost of the product. What kind of conversations has the Minister had with his colleague the Minister of Finance in terms of increasing tobacco cost, tobacco taxes to help reduce consumption and then the need for cessation and health promotion programs and so on? I know we have had one small increase in the time that I have been here as an MLA. Is that part of an overall program or plan for reducing tobacco use, and is this something that the Minister of Health is discussing with the Minister of Finance? Thanks, Mr. Chair.
Thank you. Minister.
Thank you, Mr. Chair. Mr. Chair, in my opinion and I think the opinion of many people, what we do is a multi-pronged approach on tobacco cessation. It is not just a matter of raising taxes. Raising taxes might help, but raising taxes in conjunction with some of the exercises and programs we are putting in place to increase dialogue and encourage youth to stay off will probably give us better results. It is more expensive, and people understand. We hope to see better results.
I have many times suggested to the Minister of Finance that we need to be number one in tobacco taxes in Canada. I will continue to do that. As other jurisdictions jump in front of us, I will once again encourage the Minister to help us become number one in tobacco taxes. I know last year, we were number two. I don't know where we sit today. I will have a conversation with the Minister of Finance immediately after this and strongly encourage him to make us number one. Thank you, Mr. Chair.
Thank you. Mr. O'Reilly.
Thanks, Mr. Chair. That is helpful. I look forward to hearing more information about it from both Ministers. I know there has been some discussion about how we can get the message out better about the impacts of tobacco, particularly to young people and people in small communities where the rates are higher. What is the department looking at in terms of tailoring its communications efforts and overall programming to try to reduce tobacco use amongst youth and in small communities? Thanks, Mr. Chair.
Thank you, Mr. O'Reilly. Time has expired, but I will allow the Minister to respond.
Thank you, Mr. Chair. Mr. Chair, there are a number of things that obviously need to be done here. I have had a conversation with a large number of leaders in communities across the Northwest Territories and had the conversation about how we get the message out in your community, recognizing that the vehicle in one community might not be the same as the vehicle in the other community. I have had some good feedback. In other areas, I haven't heard too much.
We are trying to reach out. I have directed the authority, through the deputy minister and the CEO, to reach out to the communities to figure out how to communicate information that is important to them in a way that will resonate in their communities, recognizing it may be a different mechanism by community. That is not just about smoking cessation. That is about messaging about when are health providers going to be in your community, who is coming in, when are they coming in, what programs or resources are new to help make sure that our people are informed. That will certainly include work on smoking cessation.
At the same time, the communities have community wellness plans. Many of them have talked about the types of things they want to address. Some communities have chosen smoking cessation as one of the things they wish to address. Frankly, in my opinion, communities are probably some of the best people to identify how information could work. We will give them all the technical data they want. Some have customized it appropriately.
The other thing we are trying to do is: we are working with the Department of Education, Culture and Employment to renew the school health curriculum. I talked about that earlier today. I think it is very exciting. We have our Aboriginal Health and Community Wellness division. I think it is honestly the first time that Health and Social Services has actually been actively engaged in curriculum development, so it is very exciting.
In that, they are talking about current and relevant resources that could be available to schools to help encourage children to not take up smoking as a habit. Like I said, I asked the department to do some exploration around "Butthead" and see if maybe there is an opportunity to revitalize or reintroduce it, "Don't Be a Butthead," if it is something the public tells us they want. Thank you, Mr. Chair.
Thank you. Mr. Nakimayak.
Thank you, Mr. Chair. I am on page 178. On the first line, community clinics and health centres, I see there is a reduction in that. What kind of service is being reduced in this line item? Thank you, Mr. Chair.
Thank you. Minister.
Thank you, Mr. Chair. Mr. Chair, the primary reduction in that area is the $900,000 that we expect through the efficiencies of a single physician system in the Northwest Territories.
Thank you. Mr. Nakimayak.
Thank you, Mr. Chair. On the second item, there is community mental health and addictions. I know recently, the MMIW in Rankin Inlet. One of the recommendations from the MMIW to the Government of Nunavut was to have more mental health workers in the communities. I believe the week after that, the Government of Nunavut had started a campaign of putting locals from each community as a mental health support worker. I wonder if the GNWT will look at some type of a model like this. There is such a lack of mental health work in the smaller communities. I am just wondering if there are other plans to look at a model similar to this for the Northwest Territories. Thank you, Mr. Chair.
Thank you. Minister.
Thank you, Mr. Chair. If the Member is talking about the community mental health and addictions, there has actually been an increase from 2016-2017 into 2017-2018 and again into 2018-2019 for this area. What I think I am hearing from the Member, I think we are working to make improvements in that area through the next section of this budget where we are including the community youth counsellor positions throughout the Northwest Territories. I apologize. We have to make decisions, and we are focusing on Tlicho and Deh Cho as a starting point. We will be rolling through the Territories over the next couple of years. That will also be taking place up in your riding. We are hitting Tlicho and Deh Cho on round one. Thank you, Mr. Chair.
Thank you, Minister Abernethy. Mr. Nakimayak.
Thank you, Mr. Chair. That is good to hear. There is also an increase on homecare and support services. I know I made a Member's statement on this last week about the lack of home support workers in small communities and the importance of those positions for the communities. I am just wondering if there are any other plans with the new agreement with the Government of Canada and the GNWT to reinstate positions like that or create positions similar to that across the Territories' small communities. Thank you, Mr. Chair.
Thank you, Mr. Nakimayak. Minister Abernethy.
Thank you, Mr. Chair. Mr. Chair, as mentioned earlier, we have increased a number of home support and homecare positions by 11, last budget cycle. There's $740,000, I believe, in this budget from the federal government that we're using to do the pilots and the design of the pilots for community and family caregivers, and we're also doing the review of homecare. As I said to Member Green from Yellowknife Centre, we don't anticipate getting that work done in time for the next planning cycle, but we do plan on getting it in the life of this government, so that the next government can make informed decisions on where to roll out more homecare positions; but we did create 11 homecare positions last fiscal year, and those positions that have been created, most of them are filled. A couple of them, we haven't been able to fill yet, but we're still trying. Thank you, Mr. Chair.
Thank you, Minister Abernethy. Mr. Nakimayak.
No, I'd just like to thank the Minister for his responses. I don't have anything else. Thank you.
Thank you, Mr. Nakimayak. Next, we have Mr. Simpson.
Thank you, Mr. Chair. So this is the section where there's community counsellors to deal with mental health and wellness. I've said many times in this House that, not just the Northwest Territories, but Canada, doesn't treat this area of health with the respect it deserves. I think that, if you put resources into this, you reduce costs elsewhere; in income assistance, in sick days, in addictions, in youth pregnancies, and in all of these other areas. The way it stands right now, it's difficult if someone has mental health issues to go and get an appointment just to see a counsellor. It can sometimes take weeks to get in to see someone; and then maybe, you'll get a once-a-month, once-every-two-weeks, sort of, appointment schedule. I've seen it first-hand. It almost seems like, when you call up to get an appointment, they almost want you to say that you're suicidal. That's sort of the metric that they use to determine if they're going to help you or not. I think that we are greatly underfunding this, not just by, you know, a few percentage points, but to a fraction of what it should be. So if someone is having mental health issues in the community, they don't want to say they're suicidal yet, but, I mean, it is detrimental to their daily life. How many appointments per month does the Minister think is adequate to treat someone like that? Thank you, Mr. Chair.
Thank you, Mr. Simpson. Minister Abernethy.
Thank you, Mr. Chair. Mr. Chair, I do hear the Member and I do know that, in some communities, we have longer wait times than in other communities. We're certainly trying to find ways to deal with that, whether it's through processes or other means. We are moving forward with the creation of more youth mental health counsellors for kids, to get children when they're young, so that hopefully we'll have been able to address problems before they reach adulthood, which we hope will give us exactly what the Member is talking about, about people being able to function normally.
There are also other parties out there. The GNWT is not alone in providing this service. The federal government has funded a significant number of contracts in the Northwest Territories to help people who are dealing with residential school or the trauma of residential school and others. I think they have 57 people on contract to travel to different communities around the Northwest Territories and provide support.
As far as how many visits or appointments an individual has, I'm not a clinician by any stretch of the imagination and I know that a clinician will work with a client and assess what they think an appropriate schedule is as far as the number of visits, the number of meetings that they need to have. I would suggest that there is no one model that fits all. Some individuals might be good once a month, whereas other individuals might need something daily, depending on their crisis. We did put forward a new Mental Health and Addictions Action Plan in the last government and we are very close to going fully live with our Mental Health Act, which gives us some resources and tools we can use for a small group of high-risk individuals in the Northwest Territories.
So I hear the Member. We are coming out with a new mental health action plan for adults. We just did one for youth. We're also coming out with an addictions action plan for adults. So work has been done in this area, and we're always trying to find ways to improve flow and contact. As a note, if someone identifies as an emergency, and I guess this is the point the Member was talking about, you know, somebody feeling like they have to identify as suicidal even when they may or may not be, but if somebody is in an emergency situation, we can get them into the system immediately, as well. Thank you, Mr. Chair.
Thank you, Mr. Abernethy. Mr. Simpson.
Thank you, and I know what the Minister is saying. He can get someone in when they're in an emergency, but if we could stop 99 per cent of people from reaching that, I think that would be admirable. My next question is: Hay River has a constant shortfall when it comes to counsellors. It seems, they're always hiring, they're always training, there is never enough to go around. What active steps are they taking to remedy that? This is not the first time I've mentioned this. I've brought this up multiple times in the House. Thank you, Mr. Chair.
Thank you, Mr. Simpson. Minister Abernethy.
Thank you, Mr. Chair. Mr. Chair, just to the Member's comments from the last question, there's a large number of things we're also trying to do as far as supporting some prevention work around suicide, and I think that's where we're going with some of the money that we got from the federal government to do some of that work, so that we can help some of our residents earlier on, before they get, maybe, in a very dangerous situation. When it comes to recruitment and retention of qualified mental health and addictions counsellors, it's hard, Mr. Chair. I mean, we've got a national challenge in this area. We do go out through our HR unit there to do recruitment drives to try to encourage people. They've reached out to universities. We know we are going to have a challenge to fill the positions that we're creating for the youth mental health counsellors, and our staff have already started reaching out to universities to try to get some of these individuals to look to the North. We're helping people understand our compensation packages. We have some of the best compensation packages around, and we're actively trying to create awareness and recruit. We do know it is a challenging area. We're committed to continue that work, and we will get these positions filled. Thank you, Mr. Chair.
Thank you, Minister Abernethy. Mr. Simpson.
Thank you, and this sort of ties into what I was talking about earlier, and that the human resources division of Health is out there doing all this stuff to recruit these mental health counsellors and Hay River not being part of the authority, although they do have access to some of that, is sort of left on the outs. We need to fill the positions we have now, never mind the dozens of new positions that are being created. So that's my concern, is: what's going on to fix Hay River's situation right now? Are there any active steps being taken? I know there are shortfalls everywhere, but that's the section we're on and that's the question I'm asking. Thank you, Mr. Chair.
Thank you, Mr. Simpson. Minister Abernethy.
Thank you, Mr. Chair. Mr. Chair, although Hay River is still technically out of the authority, they're a separate body. We've been trying really hard to cooperate and work as a single system, and they've been very cooperative with us. I do know that they go out and they do their own recruitment. I'll ask the deputy to have a conversation with the CEO on how we might be able to join forces on some of these recruitment fairs that will help Hay River, obviously, control their costs, while allowing us to get some economies of scale. I think they'll need to be there as well because they're better positioned to speak about the collective agreements and the terms and conditions of employment than somebody who's not in that board. I will certainly see what opportunities there are to share some of our time and resources to get them down there, as well. We want to fill all these positions in the Northwest Territories, not just Hay River. I hear you, I hear you loud and clear, and I'll have the department work with the authority to see what opportunities there are to work together a little bit better here, to partner. Thank you, Mr. Chair.
Thank you, Minister Abernethy. Mr. Simpson.
Thank you. I appreciate that response. Nothing further.
Thank you, Mr. Simpson. Next, we have Ms. Green.
Thank you, Mr. Chair. Mr. Chair, I have another bit of a shopping list here of things to ask about. I'll start with the grant to the YWCA for the Rock Hill Apartments. It's been at $443,000 for quite a number of years. It's now $74,000 in this main estimate. Can the Minister tell us why this has changed? Thank you.
Thank you, Ms. Green. Minister Abernethy.
Thank you, Mr. Chair. Mr. Chair, we had this discussion in the last budget, if I remember correctly. The lease on that is coming due. The Department of Infrastructure is doing some physical assessments on those buildings, trying to determine what, if any, life is left in that building, so that we can make an informed decision on next steps. If it is determined that there is still life in that building and the Y can stay in that building, we will certainly be coming back with a supp to make the appropriate adjustment in this line. I do remind the Member that this is a grant in kind, so it is not cash. Should that building be fit to continue, we will do an adjustment. If it is determined that it is not fit to continue, we have a different problem, and we will have some tough decisions in front of us as an Assembly, but we will find a way to make sure that we are moving forward. We really need to wait for that assessment to come back, Mr. Chair, so that we can have that informed discussion. I understand that it is coming shortly. Thank you.
Thank you, Minister Abernethy. Ms. Green.
Thank you, Mr. Chair. What does $74,000 represent, then, in this context? I'm not clear about that. I realize it is a grant in kind. I am familiar with the arrangement with the "Y" but I'm not sure what the 74 represents. Thank you.
Thank you, Ms. Green. Minister Abernethy.
Thank you, Mr. Chair. Technical conversation, but it is considered forgone rent for the period of time from April 1st to the end of May in anticipation of the report coming back from Infrastructure, and then working on a way forward. Thank you.
