Thank you. Deputy Minister.
Thank you, Mr. Chair. This is an example of really strong interdepartmental collaboration. Both departments have a written agreement in place. We've got collaboration taking place at the executive level and at the staff level to ensure that the child and youth care counselling program is successful. I think, out of all of the positions, we have at this moment only one vacancy, so we've been very successful, as well, in recruiting people to these positions. What we're hearing is that it's a very valuable and valued service. Thank you, Mr. Chair.
Thank you. Member.
Thank you, Mr. Chair. That's really good to hear. One of the biggest things I notice, especially when you have one department working on any sort of initiative, there always tend to be things lost in translation, so I'm glad there is some sort of agreement there to make sure that there are some clear lines and clear responsibilities because anytime there is something missed, then the whole think kind of runs amok. I'm glad to hear that there is some collaboration. Right now, even in times of COVID, mental health is a real issue now, and we have to make sure that we keep on top of it and not be so knee-jerky. I think it's really important that we keep on top of this. Just moving along a little bit, Mr. Chair, am I allowed to ask questions on page 181?
There's a line here, medical professional development. I'm not sure exactly what that is. Can the Minister just describe what those funds are for for professional development? Thank you, Mr. Chair.
Thank you. Minister.
Thank you, Mr. Chair. The only information I have here is the description on the page that it is a grant to the NWT Medical Association for the professional development of eligible NWT physicians, so I'll ask the deputy minister if he can provide some additional information on this. Thank you.
Thank you. Deputy Minister.
Thank you, Mr. Chair. I don't have much to add. This is just part of the support that the department provides to the medical profession. In addition, we also provide physicians with support, as an employer, to engage in medical professional development through our human resources and staffing line. Thank you.
Thank you. Member.
Thank you, Mr. Chair. Where I'm going with this is: one of the biggest things, in terms of medical treatment and medical services for our small communities, and I guess for all our communities in the territory, is that, if you want to effectively treat somebody or offer them the best service you can, you have to fully understand what their culture is like and what cultures are like in small communities and understand that. I think that would make a lot of our medical professionals better practitioners and help them hone their craft. It's a little tougher if you just insert somebody from the South and put them in, say, a small community and they don't quite understand kind of the ins and outs of that. My next question is: I don't know if this has been asked, but has there been more work done on cultural sensitivity and cross-cultural training in their department? Thank you.
Thank you. Member. Minister.
Thank you, Mr. Chair. Yes, the department has been working on cultural safety initiatives since the 2013-2014 fiscal year, and what we have focused on, to define what we're talking about with cultural safety, is initiatives that are designed to address inequities experienced by Indigenous residents when accessing our health services, to improve early childhood development indicators, enable seniors to age in place, and increase the number of mental health and addiction program supports. What we want is: we recognize that, because of historic factors, Indigenous people may not be accessing the healthcare system as much as they need to. The Mental Wellness and Addictions Recovery plan addresses this issue, and the specific Caring for Our People Action Plan sets out how we're going to accomplish cultural safety within our healthcare system.
There were a number of pilot activities that the department carried out to try and understand what worked best. They did 13 of these, and they have now finished with their pilot phase and are developing a framework on cultural competency which will be introduced in the Legislative Assembly once it has been endorsed by the NTHSSA leadership council. This is really, in my opinion, well on its way to being embedded in the everyday work of the department that people take this training and they learn about the operating environment from a cultural point of view. What we are looking for as a result of this is that more staff are trained in cultural competency and that patients express greater satisfaction with the services that they have received. When those numbers start to go up, we'll know that we have started to meet our targets in this area. Thank you.
Thank you. Member.
Thank you, Mr. Chair. Thank you for that response. I'll just finish up with a short comment. I think we need to start collaborating more, working with our Indigenous governments and working at the community level. Yes, I support my colleague from Inuvik Twin Lakes on having kind of those buffers to help bridge those cultural gaps, and I'm hoping we see some more work done in that area. Mahsi cho, Mr. Chair.
Thank you, Member. I'll take that as a comment. Next, we'll go to Mr. Bonnetrouge.
Mahsi, Mr. Chair. I'm sure the Minister is well aware of my concerns about the local health centre and the staff issues there. Many of my people, my community members, have complained to me about the goings-on within the health centres. They are questioning the competencies and experience of staff, particularly nurse practitioners, the nurses, within the health centre. I'm wondering if there is a bare minimum of qualifications required to work in a small health centre. I wonder if the Minister could enlighten me on that. Mahsi.
Thank you, Member. Minister.
Thank you, Mr. Chair. I want to express some concern about us identifying people who are working in small communities in a limited number of jobs. I don't think it's fair for us to discuss their competence or qualifications in this forum. They are not here to defend themselves. We don't have the level of detail, because this is a high-level departmental budget, to provide that level of information. We have standards for health professionals, standards of education and experience that they have to meet, and there are also professional qualifications that are set out by the Registered Nurses Association and the NWT medical association. This is an area in which we want to provide qualified care, obviously, but I'm not going to be able to discuss the qualifications of people who work in the Member's community. Thank you.
Thank you, Minister. Yes, and if we could, keep the questions to the line items and to the budget itself. This is not a forum to name people, especially in the smaller communities where everybody knows everybody. Mr. Bonnetrouge.
Thank you for that, so I will dispense with my line of questioning in this area here. We had concerns that there was no communication with the community at all from any of the workers there, whether it be nurse practitioner, social services, community. There is no interaction with the community whatsoever. Anyways, so that is leading to a lot of problems there. I am just wondering on the next page, page 181, the Child and Family Services items there, I know they have a group out of Yellowknife who provides that service. I am just wondering if there is any future look into having First Nations take over a file like this in the communities. Mahsi.
Thank you, Member. Minister.
Yes.Thank you, Mr. Chair. The Assembly of First Nations worked with the federal government to develop a child and family services law that became law in January of 2020, and this provides for sovereignty of First Nations to provide child and family services care. We, the Department of Health and Social Services in the NWT, fully endorse this law and the sovereignty of First Nations to provide this care, and we are more than happy to collaborate with them and with the federal government in having communities take this jurisdiction on and provide child and family services care that meets both the national requirements and local expectations. As I mentioned to the Member for Inuvik Twin Lakes, two jurisdictions have expressed an interest in taking this area on, and the federal government does have money to assist these jurisdictions with capacity to negotiate and create their own regime. This is an area that we are very interested in seeing develop over the next few years. Thank you.
Thank you, Minister. Member.
[Microphone turned off] ...questions.
As there are no further questions, please turn to page 180. Health and Social Services, health and social programs, operations expenditure summary, 2021-2022 Main Estimates, $337,150,000. Does the committee agree?
Agreed.
Thank you. Long-term and continuing care services, beginning on page 184, with information items on page 187. Questions? Ms. Semmler.
Thank you, Mr. Chair. Just looking at the program detail, homecare and support services, it's very obvious we have gone from, in the 2020-2021, $11 million, and then it increased to $20 million, and it is remaining status quo. I know that they were talking about putting more home support workers, more hours into home support workers in the communities. Is that what that money is, or what is in that extra $10 million?
Thank you, Member. Minister.
Yes. Thank you. Yes, the Member is correct. The biggest portion of this increase, $8.4 million, comes from the First Nations and Inuit Home and Community Care funding from the federal government, and it's reflected in various categories through this budget. One million dollars is for staff to pay for unfunded elements of the collective agreement in this area. We also have a very innovative program going with Aurora College where we are doing some workforce planning with them to train people to work in long-term care as personal support workers and nurses, and so we are collaborating with Aurora College and providing some funding for that. We are also addressing again a staff funding shortfall at Avens, so that comes out to $11.3 million. Thank you.
Thank you, Minister. Member.
Thank you, Mr. Chair. Within that homecare and support services, and I see that there is long-term care and supported living, the Minister has said that there is training with the college. Within the department, is there staff looking at addressing the issue with the job descriptions where a lot of Aboriginal people who are taking Aurora College are finding they are hitting a barrier when they do not have the one year of experience as to entering after they have just finished taking the personal support worker and have been working in their practicum within these facilities? Thank you, Mr. Chair.
Thank you, Member. Minister.
Yes. Thank you, Mr. Chair. I would like to refer this question to the deputy minister. Thank you.
Deputy Minister.
Thank you, Mr. Chair. Yes, there is work happening to address the job design. Job designs are in the process of being reviewed to ensure that we can look at those barriers. There has actually been some recent experience in the Beaufort-Delta where there are certainly some lessons learned and some amendments made in a couple of cases to positions on scope of practice particularly to ensure that this was adequately being addressed. We are taking lessons learned from that experience and looking at job design and job descriptions to ensure we get it right. Thank you.
Thank you. Member.
Yes. Thank you. Also looking at long-term care and supported living, my colleague and I, we had discussed this, and we have heard the stories over the past year. I addressed it, I think it was in the fall time, and I addressed it in the spring time sitting, that a lot of our elders are in long-term care. I know we have opened it up so some of them can have one visitor and things like that. Within this fund, within this budget, is there extra funding in there or are there COVID dollars that the Minister is accessing to try to get extra community staff or support so that some of the elders who are in our long-term care are not being left alone? Because we have heard the stories of the families. I have seen the pictures of people visiting outside the window. We are lucky in Inuvik that it's ground level, and they could stand outside the window. That is not the case for most long-term cares, so I am just wondering if there is, in this budget here, because it is ongoing. We are losing our elders, and our elders are lonely in these facilities. Is there money in this budget for extra staffing or some safety mechanisms to try to have them be able to see more family and visit or things like that? Thank you, Mr. Chair.
Thank you. Minister.
Yes. Thank you. This is really a heartbreaking situation for elders. They tend to have a smaller social circle as they age, and COVID, of course, has made that even smaller. This is really not a budgetary issue. This is an issue of public health, and what I have heard the Chief Public Health Officer say is that, when most of the population has received a second dose of COVID-19 vaccine, it will be possible to relax internal restrictions, internal in the NWT, and that may include things like visiting long-term care centres. Right now, that does not happen because it is considered to be too risky. That is why there is only one designated person who goes in. In terms of this budget generally, this budget does not provide for spending related to COVID because we do not have any money that is related to COVID that goes beyond the end of this fiscal year. However, if the situation drags on and it looks like finances are an issue, I think that we would certainly revisit this area.
Thank you, Minister. Member.
Yes. Thank you, Mr. Chair. Okay. No, I just wanted to make sure. We look at and see the homecare. We see long-term care. When you're in a community the size of mine, you see people working in long-term care, going from house to house. They would have different jobs. They have different circles, and then they have family circles. They take precaution to go in. I get that the CPHO has put these rules in place to protect our most vulnerable elders, but on the other hand, I also think there's some mechanism in there for maybe some extra support for that so that people are able to do the things that the staff are doing to go in and visit and have that. It's almost been a year, Mr. Chair, and I'm looking at this budget. I don't know if that's going to have anything to do with it, but if there's money in there for extra PPE or anything like that for family members and maybe some, if they want to have more family to see them, a space where people can go in and meet individually so that it's more regularly, if that's going to cost more? I don't know. Thank you, Mr. Speaker.
Thank you, Member. Minister.
Thank you. I think for me, I'm really waiting to get to the point where most people have had their second shot, and we have a better understanding of not only of our immunity, but whether the vaccine is effective in stopping the transmission of COVID so that we can return to life as normal, in so many ways, and especially in this way. What I can say is that, while nothing is planned now, this time last year, nothing was planned either. We can change our minds and come back and meet the needs that we see through a supplementary appropriation. Thank you.
Thank you, Minister. Member.
Thank you to the Minister for that, and this is more just, the last is just a comment. We've heard really good success of uptake of vaccine in our small communities, which is great. We don't have that for our regional centres, and that's where our long-term cares are. That just extends that time. Being in the regional centre, I do know a lot of people that are hesitant to even get the first or second, like to even get vaccinated. I think that poses the issue, and that's why I'm raising it because our small communities are getting vaccinated at high rates than our regional centres. Thank you. It's more of a comment. Thank you.
Thank you, Member. Minister, would you like to comment?
Sure. The month of March is going to be a very big month for first doses, if required; second doses, for sure. There will be vaccines available in just about every community in the NWT. I'm really hoping that, by the end of March, we will have good uptake in the regional centres. I know that there are various people and organizations, like Hotii ts'eeda, even the NWT Association of Communities, who are really promoting getting vaccinated, and I appreciate those efforts. I think that all of us who are working from an evidence-based decision-making point of view need to encourage vaccination. It is the single best thing that the person can do for themselves, even the Queen said so. Thank you.
