Mr. Speaker, I have a Return to Written Question 5919(2) asked by the Member for Deh Cho on February 16th, 2023, to the Minister of Health and Social Services regarding Health Care in Small Communities.
Audits conducted in the Northwest Territories Health and Social Services Authority, including the Deh Cho region, assess how a health service is administered. The audit process consists of an assessment of appropriate documentation in an individual’s file, confirming that followup recommendation for the specific concern is documented and followed, and is compliant with the expected service standard. In addition, separate and specific audits are conducted to ensure information is transferred between health care providers or that medication information is documented and confirmed in accordance with the relevant policy.
For 20232024, Northwest Territories Health and Social Services Authority will begin a new cycle to review and implement audits for the core health services delivered to health centres and health cabins.
Patient satisfaction information is collected through a survey conducted across the territory. The most recent survey was concluded in 2022 and the report was released January 2023. Information is collected for health centres in small communities, however due to the small numbers of responses for certain questions, reporting is a detailed breakdown is not available for certain communities. The 2022 NWT Patient Experience Report can be found on the Department of Health and Social Services website. A standardized approach to audits was initiated in 2019 however this work was impacted during the pandemic due to limited capacity. Current audits are focused on reviewing the delivery of the diabetes prevention and management program.
Recent analysis of audited data from October to December 2022, for the Deh Cho region provides a baseline for future comparison. The data set was analyzed by community, as well as for the region, and currently demonstrates consistency with other regions. Trends identified in the audits will inform improvements into the delivery of services related to diabetes prevention and management.
Audits of service or program delivery are not the process to assess misdiagnosis. Investigation of a case of misdiagnosis is done through the quality review process that looks at an individual's experience with a disease diagnosis.
In cases when a diagnosis is provided in a manner that is inconsistent with a practice standard, or the person receives an incorrect, partial, no diagnosis, or did not experience receiving the information about their diagnosis in a safe manner, then a report by the person should be filed. The reported mishandling of an individual's case can be made to a health care provider or a manager within the health and social services system, the regulatory body of the health care provider, or with the Office of Client Experience. Each reported concern or complaint received by the Office of Client Experience is thoroughly reviewed.
Additionally, the reports are collectively reviewed at regular intervals to identify trends for further investigation and action.
Thank you very much, Mr. Speaker. Your Standing Committee on Social Development is pleased to provide its Report on Bill 68: An Act to Amend the Child Day Care Act and commends it to the House.
Bill 68: An Act to Amend the Child Day Care Act, sponsored by the Department of Education, Culture and Employment was referred to the Standing Committee on Social Development for review on November 3, 2022.
Committee thanks everyone who came forward in person and in written submissions for their time and candid comments. Committee appreciated the favourable response to a number of the motions and the willingness of ECE to work with us. Committee members believe the motions passed during the committee's clause by clause improved the bill. Committee accepted the new legislation with some proposed changes; one motion moved by committee was not concurred with, therefore, that amendment was not made and committee may address this concern during deliberations in Committee of the Whole or at third reading of Bill 68.
Bill 68 does not address the existing challenges of the NWT's early learning and child care sector or fix the damaged relationship between the sector and government. It does, however, put in place necessary basic rules, such as a certification process for educators, and allows the NWT to catch up with the other jurisdictions in this sector.
Committee was disappointed when seeing Bill 68. This bill presents a missed opportunity to renew the NWT's early learning and child care system and provide guidance toward the system that considers the diverse needs of the NWT environment and includes all parties. Bill 68 offers a narrow scope for amendment, with the areas open for change being limited and dispersed throughout the Act. The bill changes small sections here and there in the Act, and committee was not able to propose any wholescale amendments. Committee finds this narrow approach another missed opportunity.
Committee sees serious issues with the confidence in ECE rolling out this program. Many people think that making day care more affordable is a good thing. But how ECE has done it has created more problems. Committee did review Bill 68. This bill will not fix the damaged relationships.
It appears that the GNWT left child care operators exasperated and feeling cornered after lacking to show the intent to collaborate with child care operators from the beginning and insufficiently communicating the GNWT's larger vision of child care.
Committee finds that the GNWT showed a lack of comprehension regarding the seriousness and comprehensiveness of the issues created by forcing a fast start to the transition of the territories' child care system.
Members heard from child care providers that they have lost trust in the GNWT to responsibly guide the transition, providers sense a misjudgment in the real issues and perceive a bias in looking at providerclient relationships.
The Standing Committee on Social Development recommends that the GNWT:
Form an advisory group including representation from all parties.
Review the 2030 Early Learning and Child Care Strategy on the inclusion of child care operators in goals and vision.
Establish and share an NWT vision and mission of early learning and child care sector, including principles and explaining where the federal child care agreements fit, requiring fiveyear reviews to check if NWT is fulfilling its vision.
Conduct an independent review of the roll out of the Early Learning and Child Day Care Agreement.
Conduct an independent review of the Child Day Care Act.
Address the crisis of confidence by reconciling with the NWT ELCC sector and starting with:
Improving communication by increasing responsiveness to clients and establishing client service standards; and
Committing to explaining processes to the public before implementation, providing plain language materials and designating communication channels for operators to access ECE specialists and information.
Bill 68 introduces a new section on complaints giving parents the right to file a complaint and enabling the director to investigate the complaint. Committee understands that ECE's policy intent is to allow complaints to protect the rights of families. Committee deliberated on the circumstances where the director may refuse to investigate, and on allowing disclosure of the complainant, termination of a contract, and the right to appeal.
Currently, the director has no guidance on when to refuse to investigate a complaint. Committee thought that it was important to clarify when the director may refuse to investigate.
Committee proposed adding clarity to the complaints process by way of Motion 1, adding a paragraph allowing the director to refuse to investigate a complaint if the complaint is trivial, frivolous, vexatious, or made in bad faith.
The Standing Committee on Social Development recommends that ECE improve and provide clarity on how a person may complain about an organization's service to the public by:
Providing guidance material for the complaints process to support parents and staff; and,
Developing a policy on the complaints process.
The Standing Committee on Social Development recommends that the GNWT:
Provide investigative training to all staff involved in the complaints and appeals processes.
Make this training obligatory for all staff involved.
Build competence by ensuring that investigations are not vexatious and are appropriately carried out.
Committee heard about cases where the relationships between child care operators and parents progressed to disrepair. In such situations of a bad fit, prolonging such an unproductive relationship would be undesirable. To prohibit that in such case contract termination is interpreted as retaliation, committee found it necessary to clarify that to prohibit retaliation does not prevent contract termination.
Committee proposed Motion 3, expressing that nothing can prevent an operator from terminating a contract under the terms of that contract. Should the operator do that, it would not constitute retaliation for the purposes of the Act. The Minister concurred with the Motion.
The Standing Committee on Social Development recommends that the GNWT ensures that administrative decisions are reasonable by considering the outcome of decisions and the process to come to that decisions.
Committee has reservations about the appeals process as it is designated in the Act, as appeals are currently limited to the licensing processes. Members were generally of the view that the complaints process and the appeal process could use a review, given the expanded scope of the GNWT's role in early child education and as a result of the agreement with Canada. Given that this task is partially outside the scope of Bill 68 and would require significant policy work to see how these issues are handled in other jurisdictions, committee makes the following recommendation:
The Standing Committee on Social Development recommends that the GNWT review the appeals process in the Child Day Care Act,
a) in the short term with a view to:
Identify and make improvements to make sure that the Act clearly outlines how appeals can be requested and considered;
Clarify how complaints and appeal processes are distinguished in the Act; and,
Recommend how administrative decisions are made fairly, consistently, and in accordance with the legislation.
b) In the long term with the view to:
Fully review the appeals section;
Include comparison with other jurisdictions; and,
Result in a modernized appeal section.
While the GNWT does not provide child care services, it is even more critical that policy development considers the supply and cost of child care and addresses the provision of child care to make it sustainable. The committee determined that it would be paramount for the Minister to commit to supporting the sustainability of child care and put forward the obligation for the Minister to consider costs in Motion 4. The Minister of ECE concurred.
The Standing Committee on Social Development recommends the GNWT include in its vision of a sustainable child care system information on the following:
How to support the ELCC sector in its transition.
How to embrace NWT realities without disadvantaging any of the existing parts of the child care sector.
Considerations for licensing and supporting that proportion of the child care sector constituted by forprofit day homes.
Repeatedly, committee heard that the funding provided by the GNWT for child care is insufficient. In communication with committee, ECE expressed it is committed to working with licensed programs to support sustainability and growth throughout the system. However, committee sees a pressing need for the GNWT and ECE to act to prevent losing child care spaces in the NWT and makes the following recommendation:
The Standing Committee on Social Development recommends the GNWT recognize that the actions started under the federal agreement have initiated systems change in the NWT Early Learning and child care sector and require immediate action by the GNWT to reduce the volatility that may unfold;
And further,
Identify shortfalls in funding targets outside of the federal agreement, focused on NWT needs, including but not limited to:
Capital and operating funding allocations;
Incentive loans for new buildings and retrofits;
Campaign action attracting potential child care educators;
Bonus for child care certificate completions; and,
Strategies to support professional development for ELCC workers to allow training without impacting existing work schedules.
Bill 68 adds many regulations to the existing legislation. Committee wanted to see a duty on the Minister to engage the child care operators in developing the regulations, specifically on fees and wages. Committee welcomed the department's intent to consult and prepared a motion placing an obligation on ECE to consult on all regulations, not just those that the committee had identified as having a financial impact.
Motion 5 obliges the Minister to provide a copy of the proposed regulations to child care operators to ensure reasonable time for feedback and consider the feedback in the regulations. The Minister concurred with this motion.
Committee sees the review requirement of regulations as a solid opportunity for ECE to be inclusive and show flexibility when considering the feedback received.
The Standing Committee on Social Development recommends the GNWT view the obligation to consult on regulations as an opportunity for innovation, inclusiveness, flexibility and reconciliation and be open to considering detailed feedback.
Committee took the position that it is necessary to create an environment of certainty and clarity and ensure privacy protection for parents and children. The determination was made that ECE should have a privacy impact assessment conducted after drafting the regulations and before the regulations go into the public review phase.
Committee proposed Motion 6, requiring the Minister to ensure compliance with section 42.1 of the Access to Information and Privacy Act before recommending regulations. The Minister concurred with this motion.
All submissions pointed to insufficient child care spaces in the NWT. Presenters spoke about 300 and 400 children being on waitlists in licensed child care centres in Yellowknife. The need for spaces outnumbers licensed space in the regional centres. In the NWT overall, thirteen communities are without licensed child care facilities. Committee finds the situation alarming and urges the GNWT to respond to the need and investigate innovative options for creating child care spots without additional costs.
The Standing Committee on Social Development urges the GNWT to be innovative and identify options for increasing child day care spots at no or little costs, including, but not limited to:
Changing the ratio of educators to children under two years of age by reducing the age of the infant category to children under 18 months of age. This would create additional spaces for children 18 months and older.
Completing negotiations with NWT Housing to allow licensed child care to operate in public housing.
Creating subgroups or sublicenses to allow child care centres, schoolbased child care, and child care offered in homes to offer licensed spaces.
Create substitute lists or licensing to backfill so that if one educator gets sick, not all six kids must stay home.
Create additional lists or licensing to enable before and after school day care, including evening care, so that educators who have time can take additional hours.
The Standing Committee on Social Development recommends that the GNWT provide a response to the recommendations contained in this report within 120 days. Thank you, Mr. Speaker.
Thank you, Member for Kam Lake. The motion is in order. To the motion?
Question.
Question has been called. All those in favour? All those opposed? Any abstentions? The motion is carried. The committee report has been received and adopted by the Assembly.
Carried
Reports of standing and special oh, Member for Kam Lake.
Thank you, Mr. Speaker. Mr. Speaker, I move, seconded by the honourable Member for Great Slave, that Committee Report 4819(2), Standing Committee on Social Development Report on Bill 68: An Act to Amend the Child Day Care Act, be deemed read and printed in Hansard in its entirety. Thank you, Mr. Speaker.
Thank you, Member for Kam Lake. The motion is in order. To the motion?
Question.
Question has been called. All those in favour? All those opposed? Any abstentions? The motion is carried. The report is deemed read
Carried
Link to Committee Report 48-19(2)
Member for Kam Lake.
Thank you, Mr. Speaker. Mr. Speaker, I move, seconded by the Member for Great Slave, that Committee Report 4819(2), Standing Committee on Social Development Report on Bill 68: An Act to Amend the Child Day Care Act, be received by the Assembly and referred to the Committee of the Whole. Thank you, Mr. Speaker.
Thank you, Member for Kam Lake. The motion is in order. To the motion?
Question.
Question has been called. All those in favour? All those opposed? Any abstentions? The motion is carried. The committee report has been received and will be moved into the Committee of the Whole for further consideration later today. Thank you.
Carried
Letter To Federal Minister Of Environment And Climate Change Dated March 7, 2023, Regarding Information Sharing And Notification: Spills at Kearl Mine Site. Thank you, Mr. Speaker.
Thank you, Minister. Tabling of documents. Minister responsible for Finance.
An Act to Amend the Petroleum Products and Carbon Tax Act. Thank you, Mr. Speaker.
Thank you, Minister. Tabling of documents. Member for Kam Lake.
Thank you, Mr. Speaker. Mr. Speaker, I wish to table a document the Pharmacists' Scope of Practice in Canada from the Canadian Pharmacists Association. Thank you, Mr. Speaker.
Mr. Speaker, I give notice that on Tuesday, March 28th, 2023, I will move the following motion:
Now therefore I move, seconded by the honourable Member for Yellowknife North, that this Legislative Assembly calls upon the Government of the Northwest Territories to forgive and pause the collection of current and new lease payments and fees of all Indigenous cabin leaseholders immediately;
And further, that the Government of the Northwest Territories complete a review of cabin and recreational leases to ensure that there is no infringement of Indigenous rights through the collection of taxes and fees;
And furthermore, the Government of the Northwest Territories develop a more consistent land use policy that are representative of completed land resource and selfgovernment agreements and ongoing land resource and selfagreement negotiations;
And furthermore, the Government of the Northwest Territories provide a response to this motion within 120 days. Thank you, Mr. Speaker.
Thank you, Member for Inuvik Twin Lakes. Notices of motion. Colleagues, we will return after a short recess.
SHORT RECESS
Thank you, Mr. Speaker. Mr. Speaker,
WHEREAS adequate and affordable housing is the most important concern of many Northerners;
AND WHEREAS without adequate, affordable, and accessible housing, individuals and families lack the basis for healthy living, successful educational participation, security of employment, and participation as full members in the economies, health, and development of our communities;
AND WHEREAS excessive and unexpected rental increases in private rental units can result in debilitating rents, especially upon lowincome earners;
AND WHEREAS renters require protection and support against high costs of living for inadequate lodging circumstances;
AND WHEREAS the low vacancy rate indicates strong rental market demand and puts upward pressure on rental prices;
AND WHEREAS the Northwest Territories Residential Tenancies Act does not include a mechanism which dictates how much a landlord can increase their rent, only how often that rent increase can occur.
NOW THEREFORE I MOVE, seconded by the honourable Member for Frame Lake, that this Legislative Assembly recommends that the Government of the Northwest Territories update the Northwest Territories Residential Tenancies Act to include maximum allowable rent adjustments which are no more than the fiveyear average of the Canada Consumer Price Index;
AND FURTHER, the Government include in the Northwest Territories Residential Tenancies Act that increases to rent above the fiveyear average of the Canada Consumer Price Index can be applied for by private landlords to the Northwest Territories' rental officer;
AND FURTHER, the Government of the Northwest Territories provide a response to this motion within 120 days. And I will request a recorded vote, Mr. Speaker. Thank you.
Thank you, Member for Great Slave. The motion is in order. To the motion. Member for Great Slave.
Thank you, Mr. Speaker. Mr. Speaker, I think that my motion is pretty selfexplanatory. Over the last while we have seen an increase in rents in our market here in Yellowknife, and in some cases as much as 46 percent people's rent has increased in one month. We do not currently, as I stated, have any parameters or measures in place in the Residential Tenancies Act to protect renters against high increases to their rent. Only we limit the amount of times or when the landlords can actually bring those increases forward.
As part of this motion, I did look at a jurisdictional scan, Mr. Speaker, of different territories, different provinces, and what they're doing. Currently there are six jurisdictions that have maximum allowable rent increases, which is British Columbia, Manitoba, Ontario, PEI, Nova Scotia, and the Yukon. There are two that have jurisdictions with recommended maximum of allowable rent increases, but this is not in force, and that's in Quebec and New Brunswick. And then there are five left that don't have any limitations to the amount of the rent increase, which includes the Northwest Territories, Nunavut, Alberta, Saskatchewan, and Newfoundland and Labrador.
Mr. Speaker, why I think that this is so important to do is that given the very, very low vacancy rate right now in our territory for the rental market, private rental units, it leaves our residents vulnerable. As we can see, it's very apparent to large landlords that they can just come in and increase the rent in the apartment without doing any upgrades and sometimes not even providing any heat to the people living in the apartments. I think it sets a dangerous precedent if we don't do anything now to stop this because there's nothing that's going to stop large REITs, like Northview, from deciding that they don't want to rent to low income families and instead would rather rent to the professionals and the students that may be moving north in the next while. We need these people as well but, in this case, it's going to be on the backs of our vulnerable people. So therefore, Mr. Speaker, I think it's very important that we set this precedent now, and I welcome the debate from my colleagues. Thank you.
Thank you, Member for Great Slave. The motion is in order. To the motion. Member for Frame Lake.
Merci, Monsieur le President. I want to thank the mover for the work on this motion. I think we need to have this discussion and debate, Mr. Speaker. This is one of the tools that we can have in our arsenal to try to prevent homelessness, and I think we need as I said, we need to have this discussion and debate.
You know, if you look at the motion, this is a request for this issue to be examined. We're going to hear from the government side about this. And of course if the government is not prepared to take action, it might be the subject of a potential private Member's bill at some point. But I do think we need to have this discussion and debate. And I look forward to the response from the government on this. I will be supporting the motion. Mahsi, Mr. Speaker.
