Thank you. Okay, this one is for the residential care. Okay, the budget is good for the 20242025. I've been talking to some family members and I have I didn't talk to the people in care, but I've been talking to some family where it is hard for them especially, it is okay to visit the family that are in care, and I know there are some family that were very advocate, they really advocated for the family members that are in care so I know that they brought them back. They brought them back up North. They're in our regions in care. By there are some that are in group home. Family there wants the family to come home too, because some of these, when their family come and visit it is hard for them. Both parties, it is hard for them. It is difficult for them to leave each other because the young person or the adult that is in care is away from the family members. This is, like, going back to residential school where the family they are away from their family, their language, their culture. You know, so they so some of them are saying they would like to see them back up North in some kind of a group home setting where there is service for them, there is program and services for them. And I know about the specialized services for children and youth. It's not that I'm talking about, it's for other that can come home and be cared for by in the North where they will be near family.
So I just wanted to ask the Minister if this group home, the residential and group home facility can be extended to outside of Yellowknife in the regions where families would like to care for them. Can they provide that services to other regions?
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. You know, I hear where the Member's coming from and I understand that there's many the clients that we do have in residential care facilities are very complex and, you know, however, we all wish that we would be able to have all the service to support people. And, you know, my community is kind of like your community, it doesn't have all of the specialized services there. And we also don't have the staff that will help to be able to take care of a number of the needs of the people and to support the family on top of that. So right now what we do is we look at each individual when we review all of the people that are living in supportive living on a case by case and if there's you know, if things change in like, people that are outside of the territory, if there's circumstances that change in the territory and there's way to repatriate them back into the Northwest Territories, at least they're in the territories. But as to a lot of these clients, repatriating them into the smaller communities or the regional centres, there's just not the level of support to be able to support that resident and the family. Thank you, Mr. Chair.
Thank you. I'm going to go back to the Member from Monfwi.
Thank you. I know it is complex, but there are some that can be brought back to the North. And I only if you if the department's talking to some of the families, I'm sure. Because there are some that are there without no families. We know that. And the power of attorney, and they don't know who is the power of attorney. And I know that from talking to some of the people here who have loved ones over there, they said they only find out after the fact that their loved ones was in the hospital like, you know, and because they don't have anybody. There's no family anymore or not like, not that family anymore but it's just that the guardian is not around no more and there's no power of attorney. So the state is, but nobody contacts the family members in the North.
So I just wanted to ask the Minister if they can, you know, arrange some kind of a communication with the family members that have loved ones down south. Because I know it is hard on the loved ones that are left behind. And it's hard for the family to leave their loved ones behind. And it's just it's a repeat of what the residential school did to our people. So that's how they feel. It just feels like going back to residential school days. That's what they are saying. That's how they are experiencing the experience that they have leaving their loved ones behind, especially in the south. And it's not like down the road, it's quite a ways. So that's more of a comment. But I just wanted to ask the Minister it's more of a comment but it's up to her to reply. Thank you.
Thank you. I'll go to the Minister.
Thank you. Thank you, Mr. Chair. And we do have the Office of the Public Guardian. And, you know, if there are members of the family, like you know, the instance that you've explained, maybe the person that had passed away who was the public guardian and there's family, I would suggest that those family members reach out to the public guardian. I know that they always want to make sure that there's a connection between family members and the resident. So thank you, Mr. Chair.
Thank you. Any further Members that want to ask questions to the Minister? I don't see any hand up, I'll continue on.
No further questions. Please turn to page 212, Health and Social Services, out of territory services, operations expenditure summary, 20242025 Main Estimates, $93,555,000. Does the committee agree?
Agreed.
Thank you. Moving on to supplementary health benefits beginning on page 214. Are there any questions? I'm going to go to the Member from Great Slave.
Thank you, Mr. Chair. So I'm going to keep these pretty general, just trying to understand a little bit better the Minister's thinking behind the changes to EHB. So in the business plan, one of the items is around stewarding physical health and contributing to fiscal sustainability, and HSS has an item that says income assessment process and fee structures established and incorporated into more HSS program and service delivery areas.
And my question is with regards to EHB specifically but health programs in general, how does this improve access to health care for all our residents per the priorities of this Assembly? Thank you, Mr. Chair.
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. Mr. Chair, one of the things that within the Northwest Territories, there are many programs that we provide at no cost and we have been providing those at no cost to residents of the Northwest Territories who hold a valid NWT health care card. Many of those services, when you look across the jurisdictional scan in Canada, those are a fee for service like throughout Canada. And so within extended health benefits, one of the areas in that is they're you know, what we're focusing on right now is trying to make a program that's equitable to the Northwest Territories residents. And there are a number of clients who are low income that live in the Northwest Territories that have no services, no pharmacy service, like no pharmacare plans, no medical supply plans. So they go without. And if they can't afford it, it's a choice that they have to make between, you know, certain things that we talk about in this House frequently. Where are you going to come up with the rent? Or are they going to come up with paying for their medication. Some people you know, and so this is the area where we're looking at under the fiscal responsibility is like, the programs that we have in the health department, the ones that are core services, we're you know, like, we're not going to be those are insured services. And then there's services that we you know, that we provide. And so we're looking at the ones that you know, we have been you know, that's one thing that we've been able to do for a long time but under our fiscal responsibility and, you know, where we are to keep a program like this going, then we have to be able to find ways to pay for some of these programs. And within this program, there are other things that are being done as well as just, you know, putting the fee schedules in for income testing as well as looking at and making, I think we have drug plans that we are negotiating so that we're bringing the cost of drugs down so that residents in the Northwest Territories that are utilizing a lot of these expensive drugs, it's not costing our program on extended health benefits. It's decreasing those costs as well. Thank you, Mr. Chair.
Thank you. I'm going to go back to the Member from Great Slave.
Thank you, Mr. Chair. And thank you to the Minister for that. And thank you to her department for sending us some more information about EHB today. I really appreciate it. In the and it was a publicly accessible letter. Thank you for that.
So in that letter, it's noted that currently about 1,400 people are in the EHB program under the specified disease conditions list. The department estimates that that will grow when the specified disease condition list is dropped and the new policy rolls out in September, and the cost differential that health is estimating will be about $1.2 million. So it's an increase in expenditures for the department even with this change. And I can appreciate, you know, wanting to get folks who are, you know, finding it who fall below the threshold on to a program that allows them to access benefits. No issues there. I think it's great. Hundred percent behind it.
In previous presentations, public presentations that the department gave to Members, they used the calculator that is publicly available as well, and they spoke about band 15. So just as an example, for band 15 in Yellowknife, the net income for a single person who falls under band 15 I realize it might be different for families or folks with dependents it's $74,431 net income. So someone who's making probably in the range of $95,000 of gross income. So if you work out the average rent and grocery bill that a single person would pay even if, say, you're you know, you're a roommate, in a roommate situation, say you're at the beginning of your career in your early or late 20s, the deductible for a single person to copay into medication is $540 and you max out at I think it's 820, which is another $280 on top of that. So for that entire expenditure over a year, that's basically coming out to you know, if you're in a roommate situation, that's if you're lucky, that's a month of rent. So I guess my question to the Minister for her isn't really so much a question as a comment but, you know, how does she see someone, you know, basically paying an extra month of rent here in the capital as being an equitable program? Thank you, Mr. Chair.
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. There was a lot of numbers. There was a lot of calculations in that. I am not a mathematician, and I could not keep up with where we were at. What I can say with that, you know, is I understand that there's people out there that are not getting any services. There are people that are getting you know, and the majority of people already that may be working in positions, they may have some type of insurances. This doesn't inhibit them from applying on this program as well. So this is the payer of last resort, but it can be in combinations with other. It's not going to affect, like, NIHB clients. There's no change to that. There's no change to Metis benefits. There's no change to the senior’s portion of the EHB. That all remains the same. It's the under 59. And I hear the Member. You know, there's been lots of different concerns. We've postponed it, I think, in the last government to do more fulsome reviews. We've advocated for change. Those changes have been that's what's the delay, is trying to implement the regional calculations and that will roll out on September 1st. And so, you know, and this is one of the things that I've said to my department is that over the course of the year that it's rolling out, if there is undue hardship we will make sure that we review those cases and, you know, and have you know, hopefully be able to look at the process and what we're going to be doing with those. And I also want to know after the full year is, too, how many, you know, more people that we've assisted and, you know, if there is the costs that people are you know, if there's concerns, then, you know, to hear that feedback. Thank you, Mr. Chair.
Thank you. I'm going to go back to the Member from Great Slave.
Thank you, Mr. Chair. And thank you to the Minister. And I do appreciate, you know, that she wants to do right by the people and maintain monitoring on that. But I'm going to ask a really brief question, but it might be a hard question to answer.
Does the department anticipate now, with the bill in the Canadian Parliament going through on pharmacare, have we started to look at any anticipatory measures around how that might impact this program and some of our pharmacy medication based programs? Thank you, Mr. Chair.
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. Mr. Chair, again, our extended health benefits policy is the payer of last resort. So the new Pharmacare Act that's going through the federal government right now is specific to diabetic medication and to birth control. It doesn't include at this time, that is as far as it's expanded to. And so they would have to go through that program as we are the payer of last resort first. If they are like, if their condition is diabetes or if they want to access birth control. Thank you.
Thank you. Next on the list I have is the Member from Yellowknife Centre.
Thank you, Mr. Chairman, and I appreciate the opportunity to talk on this page. And I just want to stress that the extended health benefits concern is significant to the riding. And it's a little bit of divide and conquer that FMB may have been preaching or pushing this perspective for some time saying well, you need to do this this way and this this way and based on these types of fairness calculations. But who really decides what's fair and reasonable is us, really. And I mean when we're struggling to keep people here and a reason to stay here, I mean, folks are now being paid more whether they're in Alberta or BC and, you know, they're reluctant of wanting to stay every day becomes a different type of factor, and it's frustrating. The divide and conquer concern is by now extending it to seniors, which I'm happy, just for the record, that they're not at risk, but what it is is it finds a way to continue to marginalize the opposition to this and by saying that, well, it only now affects a small group and we're going to be income testing them and doing this and doing that. And, you know, it's just you know, there was a time that the NWT was certainly the place to be, whether it was for experience, whether it was for money in the sense of employment, whether it was for opportunities, adventure. And there were many stories have been written, that I've heard throughout my life here, and how exciting it is when you hear about saying why are people here? Well, you know, I came on a whim and I stayed, and I created a family. And so that's very important. And I think these types of changes put this at risk.
Now, Mr. Chairman, I'm being very serious but in the same token not. You know, like I'm prepared to do what we need to do to reverse this. I'm not prepared to do a hunger strike but I am willing to be serious if necessary. But we need to find a way to revisit this. And it's frustrating, and it's upsetting. And those who now are on the screening list, you know, there's so little money garnered by pushing the income test. It's just it becomes one more frustration. And I know there wasn't anyone on the campaign trail that brought us here in the swell of support that each one of us shares that didn't hear something to the effect of cost of living is frustrating. And now we're just finding new groups to pay more. And that's really what the issue is, is that new groups are paying more. And they weren't defined before but we're certainly defining them now, and we're defining them to raise more money. And I get it, we need money. But I think it's about choices. And maybe the issue I want to stress on this is the fact that sometimes we have to think things through fundamentals. And I know vote one money isn't the same as vote two. But when you talk to somebody at their door and I tell them that, you know, like oh, we need $10 million more for one program, what that really boils down to is it's about less than 4 kilometers of highway. And it really stings when you think about that. You know, what are we willing to do to collectively support people? You know, I mean, I'm sure everyone would give up an extra couple kilometers of chip seal. I know no one wants to give up their chip seal. But that said, when we think about it collectively well, we'll give up a little bit more and work together to get the ends in. And I'll tell you, there's very little as important out there when you especially as you get older now, I mean, I'm looking in this room and I'm seeing a lot of, I'll say, less young people, and nothing becomes more relevant than health as time goes on. And then you learn that health and family go hand in hand. And health is very important. And I don't want people to put their health at risk over 1 kilometer or 2 kilometers of chip seal, whether it means we upgrade the you know, the housing trucks this year and we push them back a year, or the infrastructure car, or whatever. I mean, the point is we can always find a way. We just have to want to be willing to collectively be responsible for that way. And so I'm not sure what the right approach is, but although currently a hunger strike is off the table, but I'm not going to say it won't be if we need to be serious about this. And this really affects lives. This scares people. And I think, you know, that's got to shake at the core of the business we do. And so I wish we were, as Members unfortunately Members are in the position of deletion, not addition, and that's the process of how our well, all these legislative systems work, so. But, I mean, we must revisit this. And waiting a year for a promise that we'll revisit it and whatnot, I think that that's too late. You know, whether I've heard the saying a long time ago, and it's one of my favorite sayings, and I'll end on this point, is that, you know, you cannot unring a bell. And that's what this is. It's a ringing of a bell, and it sets the tone, and it's impossible to undo. So you can change the program back all you want, and that would be great, but the truth is that once it's changed it sends that message, and that's that'll resonate with people.
So, Mr. Chairman, I'm just going to leave it at that. I just wanted to speak to the particular page. I appreciate the opportunity to do that. And I can't emphasize enough this decision has to be revisited, you know, for the sake of the many, not just the few. Thank you very much.
Thank you. I'll take that as a comment. Next on my list here is the Member from Frame Lake.
Thank you, Mr. Chair. Yeah, I I'm going to try and come at this from a slightly different angle just so we're not belabouring the point too badly on extended health benefits. But I wanted to ask specifically about the northern market basket measure and the switch to using this as kind of a determined the ceiling under which people would be covered or would have to kind of cover some of the costs themselves, increasing on a sliding scale from there. So I'd just like to hear from the department the appropriateness of using the basket measure. I know that the NWT has its own that it's kind of developed based on the federal one. I actually asked the developers of the federal one by email last week about whether the basket measure was intended to be used to determine program eligibility for programs such as this, and they were very clear that it was not developed to be used as a tool for that. Still in the process of putting together a written question on that question specifically. But I was just hoping to get some commentary from the department on, you know, why that's been determined as the appropriate tool to determine eligibility for this program? Thank you.
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. As I mentioned, this extended health policy has been reviewed. I know that there was in the last government, it went back out to review because of a lot of the concerns. There was recommendations to make changes. Those changes were made. How we use this you know, what tool we use to measure low income, you know, there is a jurisdictional scan across Canada on how other jurisdictions provide any type of support to low income, and you know, and some of the you know, and I know we provided information to committee on this. There's been many presentations. There's you know, like there were provided on this topic. And right now where we're at is that that is why there's so many different layers of this. And so there until you hit I think it is about and I'll take example for Yellowknife. Until you hit a net take home of $60,000 and that's a single person you don't have to pay a deductible for your pharmacy but you may have to pay up to $400 a month. And that's the maximum that you may pay over the year. So that you know, and that's for any prescriptions. The maximum that they might have to pay for medical supplies in that group is $500 a year for their medical supplies. Anything after that, it's covered by it doesn't matter what it is, it's covered by the Northwest Territories. And so the low income is set there to ensure that the low income people have access to all of those, as well as that is the line where the dental and the vision is also eligible in that group. You know, and whether that's the tool to use, I know that the Minister that Minister Cleveland has the same tool in income support. And so what we're trying to use is we're trying to streamline. And I know that that's a conversation that we've all had is trying to use the same tool where we're measuring all our programs that we're income testing that we're using the same tool across the GNWT. Thank you, Mr. Chair.
I'm going to go back to the Member from Frame Lake.
Thank you, Mr. Chair. And, really, not to repeat comments made by other Members, but I think, you know, the problem that I'm seeing is I still have constituents who seem confused about what's happening. The department has produced kind of a calculator, but there still seems to be some confusion about kind of what their benefits are going to be. So anything the department can do to kind of improve comms on this would be appreciated. But, you know, I can just say for the record as it currently stands as it's been presented, I'm not in agreement with the changes that are being made. I'll leave it at that. Thank you, Mr. Chair.
Thank you. Is there any further questions from Members? I don't see any. I'll continue on.
No further questions, please turn to page 215. Health and Social Services, supplementary health benefits, operations expenditure summary, 20242025 Main Estimates, $35,321,000. Does the committee agree?
Agreed.
Okay, Member from Range Lake, we're talking about what I just spoke on, correct? Okay, all right, you've got ten minutes.
Thank you, Mr. Chair. So we are on supplementary health benefits? Yes, okay.
So the Minister has seen the AOC report calling for a pause to income testing this program. And I believe that's, I think, enough to understand the disposition of the House or this side of the House on that initiative.
Should that income testing be paused, what would that do to the appropriation for supplementary health benefits? Thank you.
Thank you. I'm going to go to the Minister.
Thank you. At this time, there's no I mean, the program is set to go live September 1st, Mr. Chair. And next month, they'll be opening up the process for people to start applying through the program. And then, you know, those questions that are out there that what their eligibility, what the questions, how much, you know, it might cost individual members, that's why we're opening up the application process earlier on. But as this time, the program is going to change because if it doesn't, then there's 2,200 people that are still in the Northwest Territories that are not getting any services under this current policy. And so that's why, you know, nobody seems to be thinking about those 2,200 people. If we don't change the policy to include those, right now the policy is disease based. So thank you, Mr. Chair.
Thank you. I'm going to go to the Member from Range Lake.
Thank you, Mr. Chair. Well, let's talk about what we're talking about. We're not talking about stopping the change to the beneficiaries. We're talking about scrapping the income testing. That's the issue that has been raised, or that's the request. It's not an all or nothing. If it was all or nothing, we would just delete this and the government would have to come up with a new proposal. So how would that affect this appropriation? If we scrap income testing, we add the 2200 people the Minister spoke of because I think those I firmly believe those people need care or need access to these benefits, and I support that part of the change. So if we add those people and make no other changes, does what what is the financial cost to government to do so? Thank you.
Thank you. I'll go back to the Minister.
Thank you, Mr. Chair. I will pass that over to the ADM.
Thank you. I'm going to go to the ADM.
Thank you, Mr. Chair. So we've estimated that the cost of providing benefits to those that currently do not have benefits is about $2.5 million. We've estimated that the additional revenue that will come in from the copayments by those that are deemed to pay them is $1.2 million. So the shortfall that we are incurring right now is approximately $1.3 million. However, there is work ongoing at the department, which has been ongoing for a couple years now, to bring down the cost of the benefits that we're providing under those programs most specifically related to drugs. There's been significant amount of work to enter into product listing agreements with drug manufacturers over the past few years. The work on those to get those rebates has been significant but at some point it's going to reach. We're going to max out because we'll have all of our agreements in place. So currently, in 20242025, we expect rebates of $3.2 million on that work, and which just kept us within our budget for the Extended Health Benefit Program. So the shortfall is $2.5 million, is what we're estimating, because at this point we would not be able to predict any future PLAs to a significant magnitude. Thank you, Mr. Chair.
Thank you. I'm going to go back to the Member from Range Lake.
Just a thank you. I appreciate having that kind of cost accounting. So just to be clear on the shortfall, so if it's costing us $2.5 million to bring new beneficiaries on board and the income testing is going to generate $1.2 million, is the shortfall not $1.3 million, then, because of the new revenues coming into the program? Thank you.
Thank you. I'll go to the Minister.
I'll pass that to the ADM.
I'll go to the ADM.
Thank you, Mr. Chair. I gave the cost without the income assessment.
Thank you. I'll go back to the Member from Range Lake.
Okay, so it's so $2.5 million would be the entire program with the 2200 people added? Thank you.
I'll go back to the ADM or to the Minister.
