Agreed. Thank you. Next, we have nursing inpatient services, operations expenditure summary, $35,900,000, from pages 187 to 189. Any questions? Mr. O'Reilly.
Thanks, Mr. Chair. Our friends advised that this is where midwifery services are to be found. There are additional resources in here. Maybe if you could have somebody remind me of that and with a brief description of what the resources are going to be used towards? Thanks, Mr. Chair.
Thank you, Mr. O'Reilly. Minister Abernethy.
Thank you, Mr. Chair. There are a number of increases in this area. It's not all midwifery services. Some of it is some additional positions in intensive care, long-term care, and medical-surgical nursing to help implement Stanton and a few other things. There is $373,000 in here for midwifery program expansion, to help us move forward with the territorial midwifery program. It's a couple of different midwifery positions in Yellowknife and Hay River. Maybe I will go to the deputy minister, who can go through in greater detail exactly where those investments are to help us move forward with the territorial midwifery program.
Before we do that, just one quick note. When we made those changes around CFS that we talked about earlier, there was a half-time position which was a midwifery consultant that was vacant, that we took those dollars to roll into the CFS position. That's not in this area. That position was actually in the admin section, which was the first page we reviewed today. That reduction occurred there. It's not actually part of the midwifery program. It was a consultant position, half-time, vacant. Thank you, Mr. Chair.
This year's budget includes $373,000 for three positions. One of them is a midwifery clinical specialist in Yellowknife. That's one FT. We have a midwife position, a three-quarter FT, for Yellowknife as well, and a three-quarter for Hay River. When you combine the total investments, our funding will be $1.789 million for midwifery. We're going to move, this year, to have a program that has, with the successful passing of this budget, 8.5 full-time equivalent midwives in the Northwest Territories, which will turn this program into one of the most robust midwife programs in the country, when you consider that Saskatchewan has, for their whole province, 15, and all of the Maritime provinces combined have 13.
With the addition of these resources this year, we are going to have the potential for a very strong program for women, and not just for maternity care, but also, using the model that we are rolling out, it is going to be an approach that will build capacity in other positions in communities to support perinatal care and education. This is really the movement to a hub-and-spoke model. This will be part of a multi-year plan where we will have made significant progress on implementing the Midwives Stakeholder Report by the end of this term, with a little bit more to do in 2021.
Thank you, Mr. Cooper. Mr. O'Reilly.
Thanks, Mr. Chair. The deputy minister writes a pretty good Minister's statement there. That is excellent. All good news.
More seriously, though, it would be helpful to get this out, because I think it is a good news story, and the Minister knows that I have been bugging him about this for at least three years, as long as I have been here. It is a good news story, and I do appreciate the work of the department and his staff to move this forward.
This is a great investment of money and will have long-term payoffs, all the way down to those kids who will become productive adults in our society. I appreciate the Minister and his work on this, and I thank him very much. Thanks.
Thank you, Mr. O'Reilly. Minister Abernethy.
Thank you, Mr. Chair. I was waiting, and I am still waiting for the "but." However, I appreciate the Member's comments.
This really goes to the question that the honourable Member for Tu Nedhe-Wiilideh asked earlier about early childhood development and the types of things that we are doing. This is one of those areas where, with the pre- and the postnatal services that these people provide, what we can do at a territorial level can really, I think, make some profound benefits and impacts on residents across the territory.
We look forward to seeing this roll out over a number of years and become a strong program, even though, frankly, we are better than some at this point, but there is a lot of room for improvements.
Thank you, Minister Abernethy. Mr. Beaulieu.
Thank you, Mr. Chairman. I just have one question. Maybe I will seek some clarification first. We should have a midwifery program in Fort Smith, because that has been up and running forever, and one in Hay River, and then some midwifery here.
In Fort Smith, half of the babies born in Fort Smith don't come to Yellowknife, approximately. Are we expecting the same type of numbers? Has the department done an evaluation? Fifty kids are born in Fort Smith every year. I am assuming it is, like, 60 in Hay River. I am not sure, but I am thinking it is around those numbers.
I am wondering if those are the types of numbers that the department is looking at, about half the kids in Hay River being born in Hay River, as opposed to all in Yellowknife. Thank you.
Thank you, Mr. Beaulieu. Minister Abernethy.
Thank you. We are looking at a hub-and-spoke model here to roll out a territorial program, which is consistent with some of the recommendations that were provided. It doesn't mean that births will be facilitated in every community, but where the numbers permit, we are certainly willing to explore growth in those areas. Over time, that may change, so we need to be flexible.
We do know that, in order for a midwife to remain current in her competency, for her licensing purposes, he or she does have to facilitate a certain number of births, but that is not the only job. Right? For a midwife, it is a lot of the prenatal and the postnatal that really adds some of the profound value to healthy families, healthy, strong mothers, and healthy babies.
With this model, we will be working with people in the communities, different professionals in the communities, to help enhance those services across the territory. This is the first step in the rolling out of this new territorial approach, and we will need to continue to evaluate, and that includes looking at numbers of births, in order to figure out how to keep resourcing this properly moving forward. Thank you, Mr. Chair.
Thank you, Minister Abernethy. Mr. Beaulieu.
Thank you, Mr. Chairman. Of course, my, it's not even a concern, actually, it's a wish that the young ladies from Fort Resolution who are having babies in the future, that they would end up here. They end up here in a boarding home for three weeks prior to the birth of a child. They have to fly here. It is quite a ways off because they are part of, I guess, if there is such a thing as Yellowknife Health and Social Services at this point, but I know that Lutselk'e and Fort Resolution are both under Yellowknife. If we had midwifery services in Hay River, fully functional in taking care of Hay River people, what would it take to just have the people from Fort Resolution have their babies in Hay River, as opposed to coming to Yellowknife? It is very easy. They can get there a couple of days before they have their child, because they will be in vehicles, not in planes.
I am wondering if the department has had any thoughts about this. We have a nice, big health centre in Hay River, and midwifery services now, and doctors. I am wondering if there are any thoughts of the kids from Fort Resolution being born in Hay River? Thank you.
Thank you, Mr. Beaulieu. Minister Abernethy.
Thank you, Mr. Chair. One of the nice things about moving to a single authority, with the exception of Hay River and the Tlicho, is that it actually allows us to have this discussion, which is a discussion that we weren't able to have before when services were provided for a group of people.
Now, certainly, we can explore the possibility of mothers who meet the criteria for midwifery-supported birth can explore possibly having that birth in Hay River. There are some conditions around the birth. I think, for some situations, a first birth is something that we can't facilitate. If a medical assessment demonstrates that there is a risk during pregnancy, we wouldn't be able to do that. We don't do that now. They come out of Fort Smith or they come out of Hay River if that is the case. We are not all the way there. This is really year one, start of implementation. The clinical supervisor, one of the positions that were created, is going to be the one to help us figure out how to facilitate that moving forward.
I think your dream is one of the ones that we are trying to actually get to on this particular model. It is going to take us some time, but it does make sense. It also could provide us some really solid results for those non-risk births out there that are happening in Fort Resolution and other communities in close proximity to our midwifery services that already exist.
Thank you, Minister Abernethy. Mr. Beaulieu.
Thank you, Mr. Chair. That is great news that we are working in that direction. I think that, of course, there are other communities nearby, like the Minister said, that may require more nurses or more doctors, even in Hay River, to accommodate the convenience for the people that live in communities near Hay River as opposed to near Yellowknife. I think that, if the department has that in mind and they are moving in that direction, I am very supportive. That is all I have. Thank you, Mr. Chair.
Thank you, Mr. Beaulieu. Minister Abernethy.
Thank you, Mr. Chair. I think that the Member did a really great job of explaining the hub-and-spoke model that we are trying to apply in many of the services that we provide.
Like I said before, without moving to a single authority, we wouldn't have had this opportunity. We are still in the early days of contemplating some of these opportunities that have presented themselves by having this new model, and we are excited by some of these opportunities. This is clearly one of them.
Thank you, Minister Abernethy. Any further questions? Good. Committee, if there are no further questions, I will call the page. Nursing inpatient services, operations expenditures, summary, 2019-2020, main estimates, $35,900,000. Does committee agree?
Agreed.
Thank you. Which brings us to Health and Social Services, supplementary health programs, operations expenditure summary, 2019-2020 Main Estimates, $32,078,000, from pages 190 to 192. Mr. Beaulieu.
Thank you, Mr. Chairman. I'm eligible for extended health benefits. Thank you.
---Laughter
Thank you. Mr. Beaulieu.
Thank you, Mr. Chair. I have a question on the harmonization of the Metis health benefits and the non-insured health benefits. I'd like to ask the Minister if he could just talk about that a bit, just to ensure that everybody is getting all the benefits they should be getting. Thank you, Mr. Chair.
Thank you, Mr. Beaulieu. Minister Abernethy.
I'm not 100 percent sure what the Member is asking. Are you asking about the comparability of the Metis health benefits compared to the non-insured health benefits that are offered by the federal government? I'll note that the Member is nodding his head in what appears to be the affirmative, so I will do my best to answer the question. The Metis health benefit mirrors exactly the non-insured health benefits program as far as formulary and coverage levels. I don't know what else the Member wants me to say, other than it is an exact mirror of that so that all the individuals covered get the same.
I will note, Mr. Chair, that the supplementary health benefits that we provide are not a payer of first resort, they are payer of last resort, so we would expect that employees who have health benefits, Metis employees who have health benefits, would use their employer benefits before they access the Metis health benefits. In some cases, that may result in what appears to be a greater degree of support or coverage for individuals, but we would encourage Indigenous people to use their employer's insurance, as well, because sometimes employer insurances are better than NIHB. Thank you, Mr. Chair.
Thank you, Minister Abernethy. Mr. Beaulieu.
Thank you, Mr. Chair. Is the increase the number of people or enhancement to the benefit? On the Metis health benefits, the increase of $400,000. Thank you, Mr. Chair.
Thank you, Mr. Beaulieu. Minister Abernethy.
Thank you, Mr. Chair. Those are based on demand. Not an increase in the level of coverage, but in the number of people accessing, or possibly the complexity of some of the cases. Many different clinical things could drive those costs. We know the costs are up, and we want to make sure we have the dollars to cover them, so the increase is for that.
Thank you, Minister Abernethy. Mr. Beaulieu.
Thank you, Mr. Chairman. On the medical travel, there is a drop of $3 million. Is that $3 million picked up somewhere else in this budget? Thank you, Mr. Chair.
Thank you, Mr. Beaulieu. Minister Abernethy.
Thank you, Mr. Chair. The decrease in that area is as a result of some of the corrections that we were trying to do earlier in the life of this government. There was a suggestion, or rather a direction, to modify some of our co-payments and save some or collect some more revenues in this particular area. This decrease basically represents that change of $2.4 million.
I will note, however, Mr. Chair, that line doesn't show some of the money we're getting from the federal government, $5 million to support medical travel, as well.
Thank you, Minister Abernethy. Mr. Beaulieu.
Thank you, Mr. Chair. Just to be 100 percent clear, what is not really $3 million but $2.4 million is a decrease in the medical travel is co-payments? Thank you.
Thank you, Mr. Beaulieu. Minister Abernethy.
Mr. Chair, originally that's how we were hoping to obtain the $2.4 million in savings. We have done some more analysis; we have done some more digging. We wanted to make sure that we didn't adversely affect many of our residents. Most of the co-pay comes from insurance providers and others, so we've done some tweaking around that. I'm in the process of trying to finalize that work now. I met with committee a number of months ago, where we showed some scenarios. We've taken feedback from committee to make some changes to what we were proposing. We're very close to being ready to come back to committee on that. It doesn't change the $2.4 million, but it changes how that will be realized. I'll be coming to committee shortly, once we've finalized a few more little pieces. Thank you, Mr. Chair.
Thank you, Minister Abernethy. Mr. Beaulieu.
Thank you, Mr. Chairman. On extended health benefits there is an increase of, I guess, $1.8 million. I'm wondering if that's an increase in the number of people now eligible for extended health, or an increase in the benefit. Thank you.
Thank you, Mr. Beaulieu. Minister Abernethy.
Thank you, Mr. Chair. Extended health benefits have not changed, as far as what is provided. It is still consistent with what is provided through NIHB. This is demand-driven.
Thank you, Minister Abernethy. Mr. Beaulieu.
Thank you, Mr. Chair. That's all I have, thank you.
Any further questions from committee? Ms. Green.
Thank you, Mr. Chair. I also had questions about the medical travel amount. I heard the Minister say that he is "tweaking," finalizing, and he will be coming back to the committee, but my question is: what portion of this $2.4 million will come from individuals, versus the amount that will come from insurance companies? Thank you.
Thank you, Ms. Green. Minister Abernethy.
