Debates of May 29, 2018 (day 31)

Thank you, Mr. Speaker. Mr. Speaker, my questions will be to the Minister of Education, Culture and Employment today. In my Member's statement, you heard me talk about the community in Sambaa K'e, about their school expansion and the issue about the gym. My first question to the Minister: the architects in the department made a commitment to come back and give them alternative options there. Has the department provided these options to the community? Thank you very much, Mr. Speaker.

Masi. Minister of Education, Culture and Employment.

Thank you, Mr. Speaker. Most Members know that I just took over this portfolio a month ago, and so I didn't know what was going on before that time. However, I did ask the department, and they told me that no options were developed specifically for the community. However, at a community expansion meeting held in October 2017, the department confirmed that there was sufficient space on the land reserve where a larger community gym could be built. I don't believe, according to my notes, that they looked at different options, but they did reaffirm that the space that the school was on could actually support a larger gym if that was what the community wanted. Thank you, Mr. Speaker.

I thank the Minister for that answer. I realize she wasn't the one in there, but my big problem is that the community was promised to have some alternatives in the expansion. We will probably have to disagree with that, and we will probably have to try to get the Minister in there.

My next question, though, is in regard to this. Without having a good gym in this community, we have a safety issue. How is the department working with the community and the school to ensure that they have quality and safe education programs in the school?

Quality and safe education in the community; I am guessing you are meaning facilities in the community. Student safety is a primary focus within all education systems in the Northwest Territories. Every school has a safety plan. We make sure that we take care of the children as best as possible. Incidents will occasionally happen. As soon as incidents happen, we go in. We do an investigation. We make sure that that issue hopefully wouldn't happen again. We look for solutions for that. I know that, if there are issues with gyms, et cetera, if we don't have that support, then we look at other ways within the communities that we can actually provide the activities, physical activities for children, but still making sure that they are supervised within a safe manner.

I might be a little bit confused about the MLA's question, but I am trying to answer it the best that I can.

I apologize to the Minister. Maybe I should write the questions and send them to her so that I get clearer direction of what I am trying to ask. So I must apologize to the Minister for that. I am hearing a lot that the government is not going to put a gym in this community because of the population there, so will the department work with the community to come up with a plan, and, if that plan involves going to the federal government, will they work with the community to actually approach the federal government to provide a gym, a community gym, so they can have safe, quality recreation programs?

Gyms are important in communities. Children need to have physical activity, so the Department of Education does try to make sure that there is some kind of facility. In communities where there are under 150 students, it is not feasible at this time to actually put in a school gym, so what the department does in that case, they try to work with the community to make sure that there is activity to a facility that children can access as a gym. So, in that community, I know that they are looking at building a new gym or extending it, so, in that case, we are more than willing to work with the community.

I should state, though, that it's not only working with the community. We will work with the Department of Municipal and Community Affairs because, the Department of Municipal and Community Affairs, their mandate is to actually work with community governments to access federal funding for capital projects. How do I know that? I just happen to know that, Mr. Speaker. So I promise I will work closely with the community and with the Department of Municipal and Community Affairs to address the need for a community gym.

Masi. Oral questions. Member for Nahendeh.

Thank you, Mr. Speaker, and I understand what the Minister has said, and I thank her for that. I know the reality. I was there when they built it. It was a community hall, and they expanded it to make it a "community gym." It's not a community gym. It's a large meeting room. So, the Minister, I know she is really busy because of a lot of work that she has to do over this summer. Is she willing to work with me to go into the community, have a sit-down with the community, discuss it, see for herself what the community is talking about, and see what the department is calling a gym right now? Will she make that commitment?

As a Minister, my responsibility is to represent all communities and all residents of the Northwest Territories. I would be more than honoured to actually go with the Member to the community to actually work with the community and see what we can do to support them. As the Member stated, my schedule is very busy over the summer with all of the graduations that are taking place, but as soon as we can find a mutually agreeable time, I am more than willing to go in. Thank you, Mr. Speaker.

Masi. Oral questions. Member for Sahtu.

Thank you, Mr. Speaker. Further to my Member's statement, my question is to the Premier, Minister of Executive and Indigenous Affairs. With the growing employees in the Sahtu region and departments, can the Honourable Premier elaborate and give consideration to the position for a Sahtu regional director? Mahsi.

Masi. The Honourable Premier.

Thank you, Mr. Speaker. In the 16th Legislative Assembly, the Government of the Northwest Territories had five regional directors, including a regional director for the Sahtu, and, in the 16th Legislative Assembly, the government of the day saw fit to reduce the number of regional directors from five to two, so we have a north and a south regional director. It was seen as a cost-saving measure, and, also, the fact is that, at that time, it was felt that the workload did not justify the need for a regional director in every region.

The 16th Assembly to the 18th, two Assemblies later; in consideration of our physical positive position, would the Premier reconsider this reinstatement for this position here before the end of the 18th?

Through decentralization and a number of other Government of the Northwest Territories initiatives, the programs and service delivery is being done by departments and agencies in the Sahtu, and we have recently increased the management with the superintendent of infrastructure position, so now all Department of Infrastructure projects and issues are managed out of the Sahtu regional office.

Thanks to the Premier for that response. Talking about projects and employees, they are two different things here. It seems to me that, where we are growing in the Sahtu, thanks to the government to date, as mentioned in the statement, we have grown to 375 employees, but the challenge in the Sahtu is communicating to the surrounding communities when in most cases there is only annual access. So, given that challenge, would the Premier consider reinstatement prior to the end of the 18th to that position?

We travel throughout the regions, and every time we go into a region we have had a senior management meeting with all of the senior management in the region. The last few times we have been in the Sahtu, there have been no outstanding issues that would indicate that the Sahtu would be better served with a Sahtu regional director over a rotating departmental regional superintendent to chair the senior management committee. For example, in front-line workers, there were an additional 41 positions, as the Member stated, over the last two years in Norman Wells for the new Sahtu Regional Health and Social Services Long-term Care Centre, and so I think hiring those front-line workers would be a more appropriate use of scarce resources and will better serve Sahtu residents.

Masi. Oral questions. Member for Sahtu.

Thank you, Mr. Speaker, and thanks to the Premier for that response here. I will use a couple of examples. The probationary officers from the Sahtu have to report north to the Inuvik office, and the financial services personnel have got to report to Yellowknife. Those are just examples of outside decision-making authorities given to the destination of the region. Would the Premier consider providing some options to my office for further consideration of this reinstatement, if possible?

There are also four GSO positions in the Sahtu, and they are supervised and supported by the manager of regional operations, who works with the regional director who is located in Inuvik. Having said that, we are now into business planning for the 2018-2019 season or into the last year of the 18th Assembly, so, as part of the business-planning process, we always review our operations, so I will be pleased to have a look at this again. Thank you, Mr. Speaker.

Masi. Oral questions. Member for Hay River North.

Thank you, Mr. Speaker. Mr. Speaker, earlier I spoke about the plight of dialysis patients, not just from Hay River North or Hay River South but from across this territory, who must relocate to Yellowknife to receive the life-saving treatment that they need. In the South Slave, we have a beautiful dialysis centre in Hay River, a wonderful staff, and I hear nothing but good things coming from there. I spoke of the costs of housing people in Yellowknife, taking them away from their home, taking them away from their families, and the emotional and physical toll this can have on them. So, given all this, has the department looked at the business case for increasing staff at the Hay River Regional Health Centre in the dialysis unit so we can keep people in their homes? Thank you, Mr. Speaker.

Masi. Minister of Health and Social Services.

Thank you, Mr. Speaker. Mr. Speaker, I would like to thank the Member for his question. Dialysis is an important service that is provided to residents of the Northwest Territories. In the Northwest Territories, we have the ability to provide dialysis in two communities. That is the hemodialysis. We also support peritoneal dialysis, which can be done at individuals' homes and individuals' communities.

To the Member's point, I hear the Member loud and clear. I agree with the Member. We need to do more to provide those services close to home. We would prefer not to have people coming from Hay River to Yellowknife when that service is provided in Hay River. Before we move forward with considering expanding the service in Hay River, we need to make sure that we are benefitting from the other opportunities that exist for us, such as the peritoneal dialysis, which can be done in the people's homes at home, and other options, whether it is a treatment in Hay River and then a treatment in Yellowknife offset by peritoneal dialysis. I am totally saying that wrong every time I say it, and I accept that.

There is a lot of work we have to go here. I hear the Member, and we are prepared to start that work. Thank you, Mr. Speaker.

I think it is a pretty easy decision, given the numbers that I quoted earlier. It is about $200 a night, from my understanding, to put someone up in a boarding home. That is about $73,000 a year. There are always a handful of people from Hay River and, I am sure, surrounding communities in Yellowknife. We can get them their own apartments in Yellowknife so that they at least have some privacy if they are there.

I have heard of people being in Vital Abel for years on end. That is not a very comfortable way for our elders to live. Has the government looked at different ways to house dialysis patients who have to come to Yellowknife for these long stretches of time?

This is an area where there is currently a policy gap that we are actually working on. We have done some medical relocations as a result of things like dialysis, and we are certainly open to that on a case-by-case basis until we re-fix that policy.

Having said that, yes, we do have individuals stay at the Vital Abel House. If they are staying for extended periods of time, the option does exist for them to go out and get their own accommodations or stay with family or other things, at which point we would provide $68 a day, which equates to just over $2,000 a month that eligible residents of the Northwest Territories can utilize. If we have a patient from Hay River who is coming up for an extended period of time, they simply have to have a discussion with us about not staying at the Vital Abel, collecting their $68 a month, and finding accommodations which are more appropriate and suitable for them for long-term stays.

That sounds like a heck of a deal for the government. They would save $4,000 a month that way. The problem is: these people go up for dialysis, and they are told, "You might be here for a year. You might be here for two months. We don't know. We have to wait until a spot opens up."

I will take a play from the Member for Nahendeh's playbook. I will ask the Minister again: will the Minister look at different ways of housing these dialysis patients in Yellowknife?

I will say it again: we are doing exactly that. We can make $68 a day, which works out to over $2,000 a month, which is a lot of money, for someone to rent out private accommodations and purchase food. We are looking at providing more options in Hay River. Hay River has indicated that we would like to explore other ways to provide dialysis, whether that is through some dialysis in Yellowknife and some dialysis in Hay River so people can be closer to home, offset by the peritoneal dialysis where appropriate.

Mr. Speaker, I hear the Member. I get what the Member is saying. We are working on this, and we are going to find some solutions. The Member is insistent on referencing the $73,000, which is his calculation, but the Member does know that, in this House, money is allocated from particular sources. In this particular case, those dollars are coming out of medical travel. If we want to put new positions in Hay River and expand the service, we have to go through a business planning process, build the business case, which means we have to demonstrate that we have explored all opportunities. I am simply saying that is what we are doing in Hay River. When we find a solution, we will make the investment where appropriate.

Masi. Oral questions. Member for Hay River North.

Thank you, Mr. Speaker. I failed to mention in my last question that it is hard for someone to sign a lease for a year if they are told they are going to be there for maybe a year, maybe a couple months. That is part of the issue. I appreciate what the Minister is saying. I look forward to moving some money around so we can get this issue dealt with.

I have heard in the past that there have been situations where a patient might stay a couple of weeks in Hay River and receive dialysis and then a couple of weeks up in Yellowknife. There is an alternating schedule so people at least get to see their friends and family every once in a while. Are there any situations like that that the Minister has contemplated moving forward? Thank you, Mr. Speaker.

We are open to any scenario, any options that exist to ensure that our residents are getting the best care they can as close to home as possible. Every situation is different. Every individual is unique. There are individuals who are on dialysis who are receiving a different degree of treatment than others. In some cases, providing treatment in Hay River and then in Yellowknife and then somewhere else may or may not be appropriate. In short, we are always looking for options. Every case is unique. There is no one policy that is going to fit all for all patients. We need to be open to options. Mr. Speaker, we are. Thank you.

Masi. Oral questions. Member for Kam Lake.

Thank you, Mr. Speaker. Mr. Speaker, earlier today I spoke of a constituent of mine who undertook a tremendous amount of grassroots advocacy for local options for addictions treatment in the Northwest Territories. I would like to ask the Minister of Health and Social Services if he can speak to the aftercare programs that the government is currently operating and in the process of reviewing. He has spoken about it on the floor in the House before, if he can give this House an update. Thank you.

Masi. Minister of Health and Social Services.

Thank you, Mr. Speaker. I haven't reviewed Hansard, but I am pretty sure, if we go back, I indicated at that time that I don't think we are necessarily doing everything we can or even enough for aftercare. I travelled with members of the Social Envelope Committee to different treatment facilities around the Northwest Territories. We heard loud and clear that we need to do more.

To that end, we are currently working on an addictions recovery action plan. The committee has made a number of solid recommendations. I am going to be responding to those recommendations on June 1st. In short, we are agreeing with the recommendations and are happy to move forward with committee to find some ways to improve the services we are providing for aftercare throughout the Northwest Territories.

Currently, when somebody is coming back from a treatment facility, they are required to have an aftercare plan in their community, in their region, where possible. Clearly, there are gaps that we need to close. Thank you, Mr. Speaker.

Thank you to the Minister for providing that update. I know there was a lot of work that has been undertaken by both the standing committee and the Minister. I would like to ask about another issue that was raised by my constituent, which is the availability of detox services in the Northwest Territories. Can the Minister speak to those programs?

There are different types of detox. We do have a withdrawal management program. When it comes to a medical detox, we can provide those services today in different hospitals in the Northwest Territories. We provide medical detox in Stanton, and we provide medical detox within the hospital in Hay River.

The four facilities that we are contracted with for southern placement actually have access either on-site to medical and social detox, or they are contracted with another facility in their communities for social and medical detox. All of our facilities have it. We have medical detox here in the Northwest Territories.

When it comes to social detox, there are many different ways that this can be done. In some cases, it is working with Indigenous governments and taking advantage of on-the-land programs that exist that help people get away from their communities, get out on the land, have an opportunity to detach from the community setting and connect with the cultural setting.

There are many different ways that we can do both types of detox. This is an area that I think we need to also find better approaches to enhance what we are doing to be better at what we are doing. This will be included within the addictions recovery action plan.

There are, of course, a lot of discussion around a bricks-and-mortar facility. I know that, at this time, that is not really in the cards. That is what we have heard loud and clear. There is good evidence to support that. We are looking at the former Stanton Hospital site. Are there going to be any additional detox or aftercare programs operated through that lease once the new hospital opens?

In the new hospital, as in the current hospital and Hay River, we don't dedicate beds for detox, but we have beds available for detox. If somebody needs detox services, medical detox, we have the ability to facilitate that in our facilities. With Stanton, we are going to have additional beds, so that will become easier, not more difficult.

Having said that, there are also no plans to put any detox beds in the old Stanton building. The old Stanton building is completely spoken for when it comes to things like extended care, long-term care, TO/PT, other outpatient services, as well as the Frame Lake Clinic which is going to be in that building. Plus, we also need kitchens and whatnot to provide services to extended care and long-term care. So, no plans to put anything in the old hospital.

Having said that, we have been working with the Arctic Indigenous Wellness Foundation, who wants to put an Indigenous or Aboriginal wellness centre on that property. We are very supportive of this. We are working closely with them to find a way to make this a reality. They are intending to provide services to residents from the Northwest Territories that will help people be better prepared to take advantage of some of the addictions programs that we have here in the Northwest Territories. That's a great partnership. I look forward to continuing to make progress on that, and I look forward to seeing that constructed on the Stanton campus.

Masi. Oral questions. Member for Kam Lake.

Thank you, Mr. Speaker. Obviously, third-party partners are key to successfully resolving these issues, especially working with Indigenous people, so I commend the Minister for bringing that forward.

I am mindful of an answer he gave to my honourable friend from Hay River North that you need a business case to support additional spending. Given that addictions treatment and these aftercare programs are gaps that have been identified and will require a significant amount of resources to plug those gaps, is the Minister going to bring forward a costed proposal or a business case that will see more financial resources dedicated to addictions treatment in the Northwest Territories within the next cycle of business planning? Thank you.

It is a little premature for me to say for sure. I anticipate there will be some requirements for some additional resources, but I am not prepared to say how much we think that is at this point.

As I have said when asked this question in other areas, Mr. Speaker, we spend an awful lot of money in the Government of the Northwest Territories and an awful lot of money in Health and Social Services. Before we can ask for more, we need to make sure that we are spending the money right and that we are getting maximum benefit and maximum dollar for every dollar that we spend.

We do invest a lot in addictions. We need to make sure we are getting that right. It may require some re-profiling of how we spend to get maximum benefit. If we do that and still find that we need money, I am prepared to go to FMBS to make that request. Thank you, Mr. Speaker.

Masi. Oral questions. Member for Frame Lake.

Merci, Monsieur le President. In my Member's statement, I referred to an unprecedented letter sent by the regional superintendent of Infrastructure to the Minister of Lands on April 30th that attempts to override the recommendations of the review board in an almost two-year-long environmental assessment of the Tlicho all-season road.

My questions are for the Minister of Infrastructure as the proponent for this project. Did the Minister know about this April 30th letter, and why was it sent when there was supposed to be some kind of a firewall set up? Mahsi, Mr. Speaker.

Masi. Minister of Infrastructure.