Thank you, Mr. Chair. So, Mr. Chair, that is required to do -- to deal with the projected shortfall in contracted services in Beaufort Delta. So obviously NTHSSA is responsible for health and social services in the Beaufort Delta region, particularly with respect to the Inuvik Regional Hospital. The kinds of things that fall under contract services would include security, dietary provisions, catering, laundry, housekeeping, switchboard and reception services, and as well as some on-site -- any kind of on-site management support not health care related, that tends to be through service contracts. And so there is, again, as I note a net shortfall here of $791,000. Thank you.
Thank you. I'm going to go to the Member from Range Lake.
Thank you. The chemotherapy drugs -- I know this has been kind of an ongoing difficulty in trying to tamp down on, like, a very clear cost related to chemotherapy drugs. Can the Minister speak to that because these are -- these costs continue to increase, and I think one of the issues related to health care sustainability is certainly the affordability of drugs. Thank you.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. So two issues there. One is the chemotherapy drugs specifically which is what this particular item is in relation to. The services here, obviously costs are going up, drug costs are going up. There are some recoveries and some rebates as a result of agreements that are being signed in terms of providing the ability to seek some lower cost drugs, but we do have a shortage at $484,000. There's more clients requiring the drugs and then also the fact that the drugs are more costly.
Mr. Chair, more broadly, with drug-related costs and expenditures, certainly, again, I would probably defer that to Minister of Health and Social Services, but I know there is a fair bit of effort in the space to sign further and other agreements that can help lead to reduce costs on drugs, again, broadly across the board. Thank you.
Thank you. I'm going to go to the Member from Range Lake.
Okay, thank you for that. Can the Minister provide substantiation for the tuberculosis outbreak response. It's just under $600,000. What was that required for? Thank you.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. Yes, so seeking $586,000 for added expenses as a result of this outbreak. This was -- some might recall that the CPHO declared a TB outbreak in Yellowknife July 2nd of 2024, and that resulted in incremental costs. Some of the things that occurred, there was -- there were some 532 contact points relating to just a few cases, and as a result of which a fair bit of effort that was undertaken to identify those contacts, locate them, some additional supports from the public health nurses to do the contact tracing of all those individuals, then of course supported an additional costs to the clients who were receiving treatment and those that were contacted obviously increased testing, and so some additional workload to manage the additional testing and the lab work that was required, increased workload to radiologists. There's -- chest x-rays are a part of the diagnostic tool for some of the individuals who were identified or contacted. In addition, because of the contact tracing and the nature of people's movements, there was some staff travelling to communities. And last but not least, again, some additional lab supplies to help be able to move this through quickly so that there could be a prevention of any more extensive outbreak. Thank you, Mr. Chair.
Thank you. I'll go to the Member from Range Lake.
Thank you, Mr. Chair. So for the $1.9 million for the agency nurses, does the Minister have any detail on what that is inclusive of? Do we have overtime costs, travel costs, accommodation costs; is there a breakdown she can provide? Thank you.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. Mr. Chair, I don't have that level of detail here. I'm not sure if -- no, I don't have that level of detail, Mr. Chair.
Okay, thank you. I'll go to the Member from Range Lake.
Is the -- would the Minister indicate how much of this is in compensation -- direct compensation to the agencies?
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. Mr. Chair, it -- there is both, in terms of it being the cost of the contracts which would be the salary benefits to the nurses that are providing services, as well as some travel costs and accommodation costs if there's folks who are coming in from outside and require such additional costs. Thank you.
Thank you. I'll go to the Member from Range Lake.
Nothing further, thank you.
Okay, thank you. Next on my list I have is the Member from Great Slave.
Thank you, Mr. Chair. And thank you to the previous Member for asking for the substantiation on the TB outbreak. I'm curious how many staff were required for this expenditure. Thank you.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. I can tell you that with respect to the public health nurses, there were seven nurses involved. Community health had two staff involved. Public health practitioners had two folks involved. There was a physician -- one physician involved, lab technologists involved, two laboratory clerks involved, one medical radiation technologist involved. Obviously, some of those individuals, this is not necessarily full-time work and wouldn't -- would likely have required some additional efforts and additional time and staffing in order to manage the expanding workload. Thank you.
Thank you. I'll go to the Member from Great Slave.
Thank you. So just for clarification, the folks who helped on the surge response for the outbreak, their salary is then costed to this item? Thank you.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. I'm not sure that they would have their salaries entirely costed to this, Mr. Chair. I mean, I can certainly -- would expect that it's more to do with additional costing and not necessarily exclusive costing. I can double check. I'd have to go back and look at, you know, what their base salaries are or whether there was overtime incurred, and I don't have that breakdown here.
Okay, thank you. I'm going to go to the Member from Great Slave.
Thank you, Mr. Chair. Yeah, no, I would appreciate seeing that if it could be provided as well as the costing around the additional lab work, x-rays, and travel that the Minister mentioned. It just seems like an awful lot of money for a short amount of time but perhaps with more information, I'll be able to understand that better. Thank you, Mr. Chair. Nothing further.
Thank you. I'm going to go to the Member from Yellowknife North.
Thank you, Mr. Chair. First I wanted to ask a question about an additional -- well, almost half a million dollars in funding for the in-territory child and family services program within the Tlicho Community Services Agency. Can the Minister clarify why there's such a large amount of funds needed for just this particular region now, so whether -- those costs must have been unexpected somehow? So what happened that created these new or additional expenses in child and family services for the Tlicho Community Services Agency? Thank you, Mr. Chair.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. Mr. Chair, for this one, there certainly are some shortfalls being projected. Mr. Chair, let me direct that one over to the deputy minister and see if he can get that level of detail. Thank you.
Thank you. I'll go to the deputy minister.
Thank you, Mr. Chair. So there are a number of factors that are for all three territorial health and social services authorities that are requiring more money to be spent on child and family supports. It's just that the Tlicho region was unable to offset those costs from other areas so they require a supplementary appropriation for this purpose. Thank you.
Thank you. I'll go to the Member from Yellowknife North.
Thank you. Does the Minister know, does this reflect a sudden spike in, for example, children being apprehended or taken into care or something different that has happened, or these are just sort of run-of-the-mill incremental sort of forced growth costs? And if she is not aware, I can follow up later with the health and social services Minister. Thank you, Mr. Chair.
Thank you. I'm going to go to the Minister.
Yes, Mr. Chair, I was going to suggest that that -- what may or may not be happening on a broader and systemic scale is probably best directed to the Minister of Health and Social Services but if that's not necessarily required for this moment, then I'll not redirect it over there. Thank you, Mr. Chair.
Thank you. I'm going to go to the Member from Yellowknife North.
Thank you, Mr. Chair. Okay, so my next question, following up on the Member from Range Lake's questions about cost associated with agency and contract staffing, can the Minister confirm whether costs of locums -- so that's either locum nurses or locum doctors -- would that be included in that line item? Thank you, Mr. Chair.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. Not locum physicians if that's what you're seeking. Thank you.
Thank you. I'm going to go to the Member from Yellowknife North.
Thank you, Mr. Chair. So, I mean, one particular concern that I've heard related to the way we budget for agency nurses is -- I think people on the front lines have a sense that there are strong attempts to limit the budget -- the regular budget for the NTHSSA so there's resistance to, for example, you know, adequate levels of staffing or putting new staffing positions in place because that would increase the budget that, you know, we're trying to keep under control and yet by not recognizing what is needed to keep the system sustainable, those costs are actually inevitable and they keep popping up in these sups which, you know, we have a very hard time refusing certainly, especially, you know, after the fact once it's been spent, but that way of budgeting creates these sort of perverse incentives to keep sort of overly squeezing our staffing models at the front end and incentivising health authorities to just sort of hire agency nurses when they realize that they need more people, which could be involved by a more sort of wholistic and sustainable staffing models that, you know, we plan ahead for and include in the main health authority budget.
So I'm wondering if -- a question to the Minister here. If these costs of agency nurses that come through the sups end up being fed back into the considerations when it comes to overall health authority budgeting that they get sort of counted so to speak, not as just sort of extra unexpected costs but as actually as fundamental costs necessary to running of the system and that that might lead to better staffing models in the first place, that would avoid us having to pay for these things after the fact. I know that's a convoluted question, but the question is is there a feedback loop given these millions of dollars of extra costs that are coming after the fact that will allow us to plan better staffing that would prevent these costs from happening in the future? Thank you, Mr. Chair.
Thank you. I'm going to go to the Minister to the question.
Thank you, Mr. Chair. Mr. Chair, I guess I'm not sure that my observations are necessarily the same in that the Department of Health and Social Services has seen a rather exponential growth in its budget over the last sort of five years, if you will, at a growth rate or more in excess and significant than that of other departments. And largely that is driven by, well, the cost of services going up significantly but also the number of health care work staff, labour force, physicians, nurses, as well as others, for example to support the nurses that are there. So we right now, for example, I think -- or at least last week, last time I had heard, we had exactly one agency nurse in the Northwest Territories. So I don't know that -- yes, I don't know that keeping a line item when we many times will have only one is necessarily the right response. The desire to see less use and less reliance on agency nurses is shared, I suggest, across the territory and including -- and certainly across this -- within this House, but keeping the ability to do so for emergency needs at the same time is still one that is important for services. So the number does fluctuate but, again, it was certainly at a one not long ago and may well be at or near a one right now. I mean, the bigger challenges, of course, is to determine the appropriate level of total budget for an appropriate level of services, which is a much more complicated thing than I can answer right now, but is, indeed, the work that is underway both by the health sustainability unit as well as by the health administrator and then to put those pieces together, I think that -- those questions were already answered by the health Minister today. Thank you.
Thank you. I'm going to go to go back to the Member from Yellowknife North.
Thank you, Mr. Chair. I can appreciate that answer, and certainly I'm not suggesting that we should sort of ban agency nurses as they might be needed in emergency situations or to fill in urgent gaps. However, my concern is if our system becomes designed to continually rely on them, and I do hope and I want to keep emphasizing that it is important work of both the health care system sustainability unit and the public administrator, to look at appropriate staffing models as part of their work, staffing levels and what kind of staff and the right numbers of staff that are needed.
I would just point out, I mean, we have heard a number of times from the health Minister and finance Minister that, you know, we only have one agency nurse in the territory but, I mean, $2 million worth of agency nurses is more than one nurse and, you know, it does add up over time. So at any given time, I understand that there are few but it's obviously added up to $2 million, so we are still -- there is a sizable enough reliance that it's worth looking at how we can better structure the system to avoid, when possible, needing them. So I'll leave it there. Thank you, Mr. Chair.
Thank you. I'm going to go to the next Member on my list, is the Member from Monfwi.
