Thank you. Minister.
Thank you, Mr. Chair. Mr. Chair, the cost drivers are occurring in the authority, but the department is working with them to identify those cost drivers and trying to put some scope on the things that are driving costs to help us better understand the deficit so that we can get efficiencies and make improvements to get maximum bang for our dollar. It's kind of a cooperation. It's working together. Thank you, Mr. Chair.
Thank you. Mr. O'Reilly.
Thanks, Mr. Chair. I appreciate that from the Minister. Is there a specific study being done on overtime relating to nursing, or is this just kind of broader effort to look at efficiencies as part of transformation? Thanks, Mr. Chair.
Thank you. Minister.
Thank you, Mr. Chair. The second one the Member described. Thank you.
Thank you. Mr. O'Reilly.
A broader effort, okay. Is there anything specific, though, that the department is looking at doing to address overtime in nursing? Are we looking at setting service standards? What is it that the department is doing to try to address this problem? Thanks, Mr. Chair.
Thank you. Minister.
Thank you, Mr. Chair. The setting of service standards is part of the work that the department is doing with the authority, given that we've moved to a single authority. This is real opportunity for us to set those standards. That's part of the important work we're doing to try to help us control costs.
Stanton is continuing to do some work around scheduling and trying to improve their scheduling so that they're minimizing double shifts, triple shifts, those types of things, and hoping to control some of their costs that way, as well. There are all sorts of things happening. One of the big ones is, obviously, standards. The other one is individual regional operations, looking at how they're scheduling, in particular, Stanton.
Thank you. Mr. O'Reilly.
Thanks, Mr. Chair. I don't want to seek another commitment from the Minister on this, but I just want to give him a heads up that this is something I am going to ask again in the business planning for next year, so I am hoping that we've moved beyond just talking about some of this stuff and that the Minister can discuss it in a little bit more detail about what we're actually doing to address this issue, but I will leave it at that for now. Thanks, Mr. Chair.
Thank you. Anything further? Seeing none, I will call this activity. Nursing inpatient services, operations expenditure summary, total activity, $34,108,000. Does committee agree?
Agreed.
Thank you, committee. Moving on to supplementary health programs, beginning on page 192. Comments or questions? Ms. Green.
Thank you, Mr. Chair. Mr. Chair, during the business plan process, we talked about how the department was negotiating with Health Canada around the new terms and conditions for the NIHB agreement, and I am wondering if the Minister could update us on the status of those negotiations? Thank you.
Thank you, Ms. Green. Minister.
Thank you, Mr. Chair. Work continues in this area. I am not participating in negotiations, so I would like to go to the deputy minister for some detail. Thank you.
Thank you. Mr. Cooper.
Yes, we have been having ongoing discussions with the federal government around NIHB. We supported and co-hosted a round table before Christmas that looked at improvements, the administration of the program that we may have to undertake together, and I know that it was very well-received. We had leaders from all over the NWT come together and provide this feedback, and learn about how the program operates.
With the report out of that work which is going to help us improve the program delivery, we are moving to finalize some of our work on any changes that might be coming in NIHB, and we expect to be in a position very shortly to be able to announce what direction that's taking.
Thank you. Ms. Green.
Thank you, Mr. Chair. I appreciate the answer from the deputy and look forward to the decision. Did these negotiations also include adjustments to the formulary? I note the deputy talked about service delivery, but are they also about the formulary? Thank you.
Thank you. Mr. Cooper.
Thank you, Mr. Chair. We don't as much negotiate the formulary as provide input, sort of trend data that helps inform the NIHB in them developing the formulary, so it's not really a matter of negotiation. It is their formulary. We run the program on their behalf, or we administer the program on their behalf. Data that we gather in terms of both utilization and also demand for certain drugs and so on that are in demand can help the program determine what should go on the formulary next, but I think, if I'm not mistaken, I believe the NIHB are actually aligned with the Ontario formulary, so the real work on that list takes place out of Ottawa and in line with the Ontario approach.
Thank you. Minister Abernethy.
Thank you, Mr. Chair. It is more of an encouragement than a negotiation when it comes to the actual formulary. Thank you.
Thank you. Ms. Green.
Thank you, Mr. Chair. Mr. Chair, in the last few weeks I have had occasion to talk to the Health Minister about conditions that are not covered under extended health benefits. In one case, Lou Gehrig's disease, ALS; and in the other case, I addressed here in the House, which was the provision of family planning aides and medical pregnancy termination. The Minister has said that there is a review going on here, but I don't think we have very many specifics about the plan going forward with the review of the supplementary health benefits, so I would appreciate some detail on that now. Thank you.
Thank you. Minister.
Thank you, Mr. Chair. Mr. Chair, there is no question that there is pressure on the extended health benefit and supplementary health benefit programs that we provide here in the Northwest Territories, and there is the gap that has been identified in the low-income families that do not have insurance. Currently, what we are doing with the first part of this work is we are out doing cross-jurisdictional analysis and research to see what other jurisdictions are doing and how they're working to cover some of those groups that may or may not be covered, trying to get a good sense of what's out there, doing a review of our programs, where the challenges are. From there, we intend to develop a discussion paper that we can make available to the public to begin the conversation here in the Northwest Territories on where we need to go, what needs to be done. We will be seeking recommendations, input from people across the Northwest Territories, and obviously MLAs and committee as well, to help inform the direction we need to take and how we need to get there, recognizing all the challenges that face us. From there, we will work together to determine next steps. Thank you, Mr. Chair.
Thank you. Ms. Green.
Thank you, Mr. Chair. Mr. Chair, I note that some of this work like the cross-jurisdictional scan was, I think, under way during the business plan review in November. I am wondering if the Minister can be any more specific about when all that information is going to be fed into the discussion paper, and what the timing is for putting the discussion paper out? Thank you.
Thank you, Ms. Green. Minister.
Thank you, Mr. Chair. Mr. Chair, we are hoping to have a document prepared to have discussion with committee in the next three or four months; hopefully, three months. From there, we will have a discussion with committee on how to proceed. Thank you, Mr. Chair.
Thank you. Ms. Green.
Thank you, Mr. Chair. Mr. Chair, a number of years ago, the Health Minister of the day attempted to change the supplementary health benefit program without very much success. How will the Minister do differently than was done at that time? Thank you.
Thank you. Minister.
Thank you, Mr. Chair. Mr. Chair, when that occurred, that review occurred, I was sitting beside where the MLA for Yellowknife North is currently sitting, and it was my opinion of the day that one of the problems was, when that proposal was brought forward, it was brought forward as a solution without doing the upfront work. They didn't engage potentially affected stakeholders. They didn't go out and talk and have those discussions throughout the Northwest Territories, seeking ideas, input on how to resolve the problem. A couple of problems: it's very expensive, is one problem. The other problem is that we have a gap. There are low-income families without insurance that aren't covered. Recognizing our challenges, how do we address those problems, and we need to have that conversation. We don't need to go out and say: we are going to do X. That's the big difference of what we're doing this time, is we are going to pull together the data, identify the problems, go out and have conversations, talk to people, seek meaningful input on how to address those problems, and work together on solutions. Thank you, Mr. Chair.
Thank you. Ms. Green.
Thank you to the Minister for that response. At the end of the day, if and when a solution is found, does it require legislative change? Thank you.
Thank you. Minister.
Thank you, Mr. Chair. Mr. Chair, honestly, I can't say. That would be presuming a solution. I don't think we have reached that conclusion. I think we need to do the work. Conceivably, yes, but let's do the work and figure out what we can do to address our challenges and develop a plan. Thank you, Mr. Chair.
Thank you. Ms. Green.
Thank you, Mr. Chair. Mr. Chair, I will make this my last question. Given the timing of where we are vis-a-vis the 2019 election, does the Minister anticipate completing this work through to public engagement and identifying solutions prior to the next election? Thank you.
Thank you. Minister. Thirty seconds.
Thank you, Mr. Chair. That is my plan. Thank you.
Thank you. Follow-up from Ms. Green.
No. Thank you to the Minister for his responses. Nothing further.
Thank you. Anything further from committee? Mr. O'Reilly.
Thanks, Mr. Chair. I don't want to jump ahead to page 198, but that is where the non-insured health benefits are found, the funding that we get from the federal government for that. It is in the neighbourhood of $14,473,000. How is that amount reconciled against the amounts that are expended here on page 193 which show extended health benefits, indigent health benefits, medical travel, Metis health benefits? That money that we get from the federal government, how is it expended within these areas? Thanks, Mr. Chair.
