Thank you, Mr. Chair. We're talking about money that's already been spent. So you know and I know the majority of the people living in small communities are Indigenous people. And for some of the small communities, we know that without agency nurses or contract staffing for nurses, we will be without nurses. We're not going to have any services. We have a health centre but we're not going to have any staff, nobody to look after the small communities. So I do support some of -- because of that, you know, I do support where we do need -- and here we're crying, we're asking for more doctors, we want more nurses, but small communities -- and you said it before too, small communities do matter and we do need a better health care.
So with that in mind -- with that in mind, like, for the nurses in small communities -- and I know that you said locum and physicians are not in this -- it's not part of this budget here, that $2.4 million. So I just wanted to know and ask -- well, I know it's finance Minister, but I think I should be asking the health and social services Minister. I know it's hard and it's culture shock for newcomers to come in, but I just wanted to know -- and I know that there's a lot of colleges and universities in the south where it is Indigenous, most -- you know, there's a college of nurses in -- which is for Indigenous in Saskatchewan and in Alberta as well. So I just -- sometimes we do get lucky. We get a nurse that loves our community or that loves the region that stays for many years, you know, and they -- some of them stay until they retire or well beyond retirement, you know. But that's only few in between. It's not too often. So I just want to -- it would be nice if we can do something to recruit -- I know that in the North we don't have too many Indigenous nurses and doctors that were born and raised in the North. And if we do, then they go somewhere else in the south so I think we need to recruit more Indigenous nurses and doctors across from -- you know, like, from the south, from the colleges.
I don't know if it's -- could be part of this budget but I just wanted to know if there's any kind of a campaign that's happening between the GNWT, health and social services, or with the human resources to recruit other nationalities? Because I know if it's an Indigenous, hopefully they will want to stay because they come from -- many of them are from small communities, small -- like, from outside of a larger regional centre. So, and I know this is not -- this is old money that we're talking about; it's money already spent, but maybe for upcoming budget, if we can put something in there where -- because it's good for career too, a career opportunity for young people that are -- you know, that are within our region. So I just -- that's just -- it's more of a comment.
So maybe, A, we can keep that in mind for future reference, especially for small communities, for outside of Yellowknife, where it is hard to recruit. And we do need more nurses and sometimes it's the agency nurse that comes in, and we don't -- and I don't think any communities would like to see their health centre shut down because there's no nurses. And agency nurses do help in many of this -- in these areas.
So another one too is that here, to provide funding for the in-territory child and family services program with NTHSSA. But it's not just TCSA, but it's probably other region as well. So is this keeping to where -- keeping the kids in the North or in the regions? Is that -- this budget, is it part of that? Because I know that a lot of time before kids were -- when they were removed from the community, they were always sent to a larger regional centre, and there's a lot of voluntarily agreement that's being -- that's taking place. Does this budget reflect that? I'm not too sure. Thank you.
Thank you. I'm going to go to the Minister, to the question.
Thank you, Mr. Chair. And first of all, I do want to commit that the human resources -- or the health recruitment unit that does -- is a shared responsibility between health and finance. More than happy to have them follow up if there -- if we can identify the specific programs that the Member's suggesting, we'll make sure they're following up and even just generally, perhaps, take an opportunity to see that we recruiting -- we do tend to recruit almost all, if not all, graduates from Aurora College, but if there's specifically some Indigenous focused programs elsewhere, that would be very helpful. So, again, I will certainly follow up with the Member and with HRU on that.
With respect to the in-territory child and family services system, it is a function of there being an increase in need but also, again, as Members noting, the costs associated with trying to have systems or programs that can keep families together, so a higher cost for preventative programs but also that can then, you know, working with a family, there's different types and different levels of agreements, voluntary services plan of care agreements up the chain and so the more can be invested sometimes to try to fix some of the structural issues that does result with more clients and with more need, there's more costs, but that -- so, yes, you know, in some cases there still will be children who do not have a place but to the extent that they can be kept with their families or in foster care within the community, which sometimes also requires more costs, then that is -- that is resulting in increased costs. And, again, it's not just Tlicho. Just that was the only entity out of the three that didn't have the opportunity or didn't have other surplus money from elsewhere they could put toward a cost overrun. Thank you.
Thank you. I'll go to the Member from Monfwi.
Thank you. Yeah, thank you. It's more like a family preservation program too as well, yeah.
So another one too is that to provide funding to address the impact of costs associated with the tuberculosis outbreak, so it's probably mostly the Indigenous people here because the majority of the people that, you know, living in Yellowknife too, it's half/half but, you know, probably mostly -- I don't know. For that one, the funding, is it just only for -- was that money only assessed only Yellowknife or, like -- or was that, this cost association -- associated, was it only for Yellowknife only, or did some of this fund went to outside of Yellowknife as well?
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. So although the initial declaration of the outbreak began, I believe with a case that was identified here, what ultimately wound up happening in terms of the case management and the case identification, it extended to beyond Yellowknife to the Tlicho region as well as to the Deh Cho region. Thank you, Mr. Chair.
Thank you. I'm going to go back to the Member from Monfwi.
Thank you. Thank you, Mr. Chair. That's it for this section.
Mahsi. Is there any further questions from Members? I'm going to go to the Member from the Mackenzie Delta.
Thank you, Mr. Chair. On page 8, about substance use and addictions program for a modest $69,000. With the high problems that we're encountering with social problems, especially alcohol and drugs, can you elaborate on what these addictions programs are entailed with this $69,000? Thank you, Mr. Chair.
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. And, Mr. Chair, this is certainly far from being the only program or fund directed to support addictions use so happy that the Member is pointing that out.
This is one of the examples of where Health Canada came out with some additional funding and provided that funding under what is called the substance use and addictions program contribution agreement, and this one is quite specifically with respect to smoking cessation, so trying to reduce the number of individuals who are cutting back or reducing or ultimately ceasing smoking. And so it's money that's coming over the last four years. This is the current amount and it provides for tobacco sort of specific therapies, data management, and a nurse in Inuvik, registered nurse in Inuvik, that can fall under this to help provide some of those supports. Thank you.
Thank you. I'm going to go to the Member from Mackenzie Delta.
Thank you, Mr. Chair. I'd just like to thank the Minister for that detailed answer. It's encouraging to have these kinds of programs, especially when we have our younger generations populations picking up these habits, especially smoking within the small communities is so prevalent. You see these younger generations picking up these habits so thankful that, you know, these types of programs are available, should be more available, readily available within the school systems where we can attract and make the younger population more aware. Just more of a comment. Thank you, Mr. Chair.
Thank you. Are there any other Members that have questions? Okay, thank you. Seeing no further questions.
Supplementary Estimates (Operations Expenditures), No. 2, 2024-2025, Department of Health and Social Services, operations expenditures, health and social services programs, not previously authorized, $6,022,000. Does the committee agree?
Agreed.
Thank you.
Supplementary Estimates (Operations Expenditures), No. 2, 2024-2025, Department of Health and Social Services, operations expenditures, long-term and continuing care services, not previously authorized, $4,129,000. Are there any questions? Seeing no further questions.
Supplementary Estimates (Operations Expenditures), No. 2, 2024-2025, Department of Health and Social Services, operations expenditures, long-term care and continuing care services, not previously authorized, $4,129,000. Does the committee agree?
Agreed.
Thank you.
Supplementary Estimates (Operations Expenditures), No. 2, 2024-2025, Department of Health and Social Services, operations expenditures, out of the territory services, not previously authorized, $9,162,000. Are there any questions? I'm going to go to the Member from Yellowknife North.
Thank you, Mr. Chair. On the topic of out of territory hospitals and physician services, does the Minister have any sense of how this number has been changing over time? Is this typical that for a number of years now, you know, just over $6 million we've needed to spend this much extra in out of territory physician services and hospital services, or, yeah, is there any trend or pattern that we can see? Thank you, Mr. Chair.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. Mr. Chair, that's an excellent question and to my knowledge, that's exactly the kind of question that is being looked at by the health sustainability unit. I don't have the trends in the supplementary estimates document or background. I can say that this may well include some of the additional amounts that we would have incurred -- oh no, those things -- we did see certainly a bump when the evacuations took place, for example, in 2023, but that would have been dealt with in the past fiscal year. So as far as beyond that for trends, as I say, it is certainly something that's being tracked specifically by that unit. Thank you.
Thank you. I'm going to go to the Member from Yellowknife North.
Thank you, Mr. Chair. I do appreciate that answer, and I do hope they are looking at this closely. I mean, this feeds into the exact point I was making a few minutes ago, which is that I am concerned, and there's certainly practitioners within the system as well who are concerned, that the attempt to sort of tighten belts and balance budgets internally have led to a tendency to cut down on physician services that previously might have been available, at least at the Stanton Territorial Hospital if not in regional hospitals, and there's this sense, well, we can't afford it but not really recognizing that people still have to get care and we'll have to send them somewhere else for that care, but, you know, not to worry because that money will just be paid for out of sups anyway so we don't have to include it in our budget. So that's the concern and the danger of the way this budgeting is done. So I am hoping that the work of the sustainability unit and the public administrator can sort of uncover some of these patterns and stop it, especially given that we know, based on, you know, lots of studies that have been done, that it's much better if care can be provided as close to home as possible. That it's not equal just oh, it doesn't matter, just send them to the next province, send them somewhere else, it's just the same thing. You know, there's better patient and health outcomes and lots of expenses can be prevented down the road if we can provide care at the earliest possible date and as close to home as possible. It's better for everyone and better financially. So I hope that that work can produce some results soon. Thank you, Mr. Chair.
Thank you. Are there any other Members that have questions? Seeing no further questions.
Supplementary Estimates (Operations Expenditures), No. 2, 2024-2025, Department of Health and Social Services, operations expenditures, out of territory services, not previously authorized, $9,162,000. Does the committee agree?
Agreed.
Thank you.
Supplementary Estimates (Operations Expenditures), No. 2, 2024-2025, Department of Health and Social Services, operations expenditures, supplementary health programs, not previously authorized, $611,000. Are there any questions? I'm going to go to the Member from Range Lake.
Thank you, Mr. Chair. Mr. Chair, can the Minister explain why the GNWT is responsible -- still responsible for funding Metis health benefits when in a post-Daniels case world where the federal government is supposed to be responsible for this? It seems unfair that we have to shoulder that burden when it has been proven in the courts -- or tested in the courts that it is a federal responsibility. Thank you, Mr. Chair.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. I cannot see into the crystal ball of the federal government. I would be fascinated to know why they are not taking this on similar to, by way of comparison, the non-insured health benefits which is a benefit that is provided to Indigenous persons, or at least First Nations persons, and this program administered by the GNWT is meant to extend a similar level of coverage. I do not know why the federal government doesn't seem to undertake this. Thank you.
Thank you. I'll go to the Member from Range Lake.
Thank you, Mr. Chair. And, you know, I commend the government for stepping up and providing this benefit when -- instead of just not -- no one providing it at all. Has the health department or intergovernmental affairs started negotiating on this or raised the issue that this -- these benefits should be paid for by Ottawa and not by Yellowknife? Thank you.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. Mr. Chair, the more fulsome response likely lies either with the Premier or the Minister of health. I certainly can say that in the last year, and even before that, that it is an issue that does come up at bilateral meetings with the NWT Metis Nation and that, in fact, progress in terms of at least our collective or joint advocacy is positive. The president and the Northwest Territories Metis Nation actually travelled with Minister -- our current Minister when she was last there to advocate on this very issue. So while it is a bit frustrating for all of us, it is certainly an opportunity for us to share and to raise our voices collectively. Thank you.
Thank you. I'll go to the Member from Range Lake.
Thank you. I have great confidence in President Bailey and our Cabinet to press this issue at the federal table.
Can the Minister explain what the cost overage on the program is; what's driving the costs? Thank you.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. The projected shortfalls from this one, Mr. Chair -- sorry, we do have the base funding here built in. There is -- yes, I don't actually have great detail as to what has led to that, Mr. Chair. I'm not sure if the deputy minister can speak to it, but it may well be -- yes, sorry, I'll just pass it to the deputy minister. Thank you.
Thank you. I'll go to the deputy minister.
Yes, thank you, Mr. Chair. So the program is demand driven, so it is a little bit difficult to predict how much demand there will be on the system from the people that are eligible for those benefits. But just to give the Member an outline of how it's budgeted for, so there is a base budget of $2.7 million for Metis health benefits and then the program costs, we estimate until the end of this fiscal year, will amount to about $3.4 million. The department has a bit of a surplus under its extended health benefits budget, so that's $257,000. So that'll be applied to the overall shortfall in this program which is $868,000. So $868,000, taking away the $257,000 that the department's applying to that shortfall, gives you the sup request which is $611,000. Thank you.
Thank you. I'm going to go to the Member from Range Lake.
Thank you. Can the witness repeat the surplus for extended health benefits. Thank you.
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. $257,000.
Thank you. I'm going to go to the Member from Range Lake.
Thank you. So this is -- and this surplus exists after the changes were made to income testing extended health benefits; is that correct?
Thank you. I'll go to the Minister.
Mr. Chair, I'm not sure -- I'm not sure, Mr. Chair, and I don't want to presume.
Okay, thank you. I'll go to the Minister -- sorry, to the Range Lake Member.
