Okay, thank you. I'll go back to the Member from Great Slave.
Perfect, now I understand. Thank you, Mr. Chair. Nothing further.
Okay, thank you. Are there any further questions from Members? I'm going to go the Member from Yellowknife North.
Thank you, Mr. Chair. I wanted to ask just about the medical travel review that is underway of the medical travel benefit policy. I understand that there's much bigger questions to be asked about what drives medical travel, and sometimes unnecessary medical travel, and that work is being done more by the health care system sustainability unit and maybe also the public administrator. I'm not sure. But this is an attempt to modernize the policy. So one thing that has been suggested to me could help save some costs is letting those who want to or are able to book their own medical travel, book their own flights or accommodations. Often they could do it further in advance and get a better deal or, you know, just save the trouble of having someone in government do all the bookings that they could just do themselves. Is that something that's being considered as part of the medical travel policy review? Thank you, Mr. Chair.
Thank you. I'll go to the Minister.
Yes, thank you, Mr. Chair. That is one of the parts that we are looking at. Because as long as somebody -- once they're approved for medical travel, normally we'll go through our processes, and so what part of that is making sure, like, you know, anyone who's travelling from A to B, this is the -- this is what will allow for -- you know, coming up with a standard of what those costs could potentially be that we would normally reimburse for. And so I think there's -- then that's why I said it's a more of a modernization. It's being able to do things different and to allow for more flexibility but still -- but within a policy so that way it's not just going to be -- there's still going to be parameters around it, and then -- but the main thing is is that sometimes people don't realize is that any medical travel has to approved for medical travel before they can book because then if it's not approved for medical travel and they go and they -- and then it's not reimbursable, right? So that's work that will be laid out through this modernization and making sure that we are -- we are making sure that those standards and those things are in place before we roll out anything new, yes. Thank you, Mr. Chair.
Thank you. I'm going to go back to the Member for Yellowknife North.
Thank you, Mr. Chair. That is good news; it's good to hear. I think there is opportunity to save a lot of costs in that area by allowing more flexibility and allowing people to just sort of do it themselves, not just the cost of flight which might -- people might be able to find a better deal but, you know, when the system is so bogged down and people find out, like, less than 24 hours ahead of time that they're going to travel, and you inevitably end up having people miss flights and miss appointments, and then there's even more costs piled on top of -- for having to rebook. And so, I mean, I think it just kind of snowballs the costs and added strain on the system. So I think by adding more flexibility and allowing people to, you know, do the work themselves could really be beneficial in the long run. Thank you, Mr. Chair.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. Yeah, I just wanted to make one last comment on that is that, you know, there are -- you know, in one instances, yes, it's fine for those that -- but we need to make sure that we have a system in place that it is fair and, you know, and that not everybody can just book a ticket and book a hotel room. And we hear that a lot, especially when we have, like, elders who are coming from communities and, you know, they get put into a hotel or, you know, they -- so we have to make sure that this process is -- there's an equitable process for it. We also want to make sure that, you know, making sure that when things are -- service standards are set in place so that the things that you talk about that travel is not -- and there's always going to be those instances where you see a doctor and then all of a sudden it's like, no, you need to go, and so, you know, we -- those are last minute bookings, and those are things that we can't help. Just the nature of where we live. But it is all those pieces, and it's trying to also making sure as why people are travelling and when they're travelling and if that follow-up is necessary to have to travel, or can it be done in your community, can it be done virtually, can it be done when the nurses or the doctors visiting. It doesn't necessarily have to be somebody who has to fly all the way back to Edmonton because the doctor told me I needed to see you in six weeks and then you get there, and it's a two minute appointment and say, oh, you shouldn't -- I didn't realize you were coming from the Northwest Territories. So we are making sure that those kind of things -- and that's at the authority level because they're the ones that deal directly with the clients, making sure that there are checks and balances in place as who's travelling, why they're travelling, when they're travelling, and should they, you know -- and is there other opportunities within our system that we can make sure that they're getting the services that they need. So that is a bigger piece of why it's not just a policy review. It's probably more policies. Thank you, Mr. Chair.
Thank you. Were there any further questions? Okay, thank you. Next on my list I have here is the Member from Deh Cho.
Thank you, Mr. Chair. I'm trying to figure out how to word what I need to say. When people get sent out for medical travel, I guess going back to how things are done and needing to recognize how Indigenous people live and how we know that when a person is going through a medical condition, say cancer or something that might be detrimental and if they have a family member with them, we know that studies show that people heal faster, they heal well, they heal faster knowing that somebody's with them.
So I wanted to ask, like, for even with -- especially for older people, is the new changes that are coming going to include having elders have escorts travel with them especially if they have to -- if they're leaving a small -- one of the small remote communities by plane and a family member can't go -- well, the way it is now is that nobody can get on the plane with -- an escort cannot get on the plane with a person, and having to come to a unfamiliar place and -- so I wanted to know if that was going to change with this new renewal because we're here to -- we're here to represent the people that we got elected to represent and not so much this government. So I would really -- like, I would like to see that, something like that put in place, that's going to be -- so our people are supported from our smaller communities in a better way. Thank you.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. Mr. Chair, I appreciate the question and the comments, and I know that is part of what is also in this medical travel review is the escorts, and I've -- you know, I've heard from the Member. You know, I've raised the same issues. I've heard it from the Council of Leaders. I think I've heard it from every Indigenous community that I've travelled into with MLAs. And so, yes, this is part of the review, and I know that we need to consider when people are travelling from small communities, elders, language, the situation that they're going for, all of those things, and within that process trying to come up with a policy that, you know, incorporates all of that for when, you know, people -- the practitioners that are sending them so they are clear on, you know, some more areas as to what -- who can be approved for going. So those will all be measured.
However, with medevacs, it's a different situation. I think that's the one thing that people -- it's a struggle because when people are travelling in medevacs, the priority in a medevac is the patient, and so sometimes those medevacs don't have the room or don't have the capacity. And, you know, depending on the situation, there has been times where escorts have been allowed to get on the plane, depending on that. Those are case by case, though. It depends on the team. It depends on what the situation is. It doesn't always happen, and it's not something that we have, like, set things. But I do believe that we are reviewing our -- because we don't currently -- when we talk about escorts, non-medical escorts are to travel for that person on a scheduled appointment to get them from A to B. It's not, you know -- and that's why you look at it, the checklist of why people are travelling, it has mobility issues, language, because you need somebody with you if there's a language barrier. If it's a minor. You know, there's very few, but when it's a medevac, it's not considered a -- you're not a non-medical escort during medevac because the medevac team is the escort. They're a medical escort, and they're going to a facility. So this is one of the things that we struggle with because through that process when somebody is medevaced and if it's an infant, automatically they'll send next -- on the next flight or, you know, if a child or a minor under 18 because they need a decision maker or somebody there to help with them. So those are the situations. So anything else, like, if there's circumstances, they are measured as exceptions, and -- you know, and NIHB tends to be more exception when there's more of a compassion escort. But those go through NIHB, and then we have to wait to get the approval before we can provide the travel as we are the administrators of NIHB. So we wait for that approval to come back and then medical travel staff cannot book it until, you know, they get the approvals to travel, so.
There are many circumstances around medical travel, and I think over the years it's not necessarily that, you know, my physician said. We all want -- you know, we all understand that when people are sick, you know, but the nature of our demographics, it's really difficult. And, you know -- and I think last time we seen the moving of patients, I think it was about 46,000 people we moved in a year and then additionally to that, with escorts, half of them are, I believe. Thank you, Mr. Chair.
Okay, thank you. I'll go to the Member from the Deh Cho.
Thank you, Mr. Chair. Mr. Chair, I wanted to ask if -- because we're get -- the public administrator, they're going to do -- is this a correct statement that I'm going to make that the public administrator's going to be reviewing all the policies and all the stuff and making adjustments where needed? Because if that's the case, will they be -- will he be advising or consulting with the Indigenous communities? Thank you.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. If it's -- relates to medical travel, the medical travel review is actually being led by, I think, the department and working with the medical travel team within NTHSSA, I believe. So that is where the bulk of that is happening. It's not necessarily the PA. The PA is more of an overall -- works with the executive and to fulfill the mandate that's been given to him by myself, Minister. Thank you, Mr. Chair.
Thank you. I'm going to go to the Member from Deh Cho.
Thank you, Mr. Chair. Now, will the people that are organizing the -- or redeveloping or relooking at the medical travel, will they be consulting with health care professionals and providers in the communities? Because you got to find a better way of how to work with the people otherwise we're going to keep getting the calls, we're going to keep getting the calls from people that say this is not working, this is not working, this is not working. We need to find some solutions to make things work better for the people that we represent in the Northwest Territories and the ones that are specifically, I guess, dealing with NTHSSA. Thank you.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. Mr. Chair, most definitely that is -- we will -- we are going to be -- the work that we do, you know -- and I think the thing is that when people say, you know, told me a hundred times that this is a problem, we have all of that, the work is being added, every BF that every Member has sent to me, we have that as statistical data to help generate what the main issues are of our medical travel program. Also, the data that's been going into the -- like, Office of the Client Experience, especially through the Indigenous patient advocates, they have been tacking data, and medical travel is probably the highest on the list, so we have the most robust data on the issues, especially from the communities, small communities, people that are having to travel more. I mean, you know, when people travel from Yellowknife to Edmonton, yes, but when people are travelling from small communities -- like, I recently travelled into the Sahtu. We have heard from the Member from Sahtu and the community that, you know, going into Yellowknife -- or going into Norman Wells, you know, there's issues between there and the community and getting to Yellowknife. So all that information is -- has been portrayed back to the department and is gearing the work that they're doing, so it's kind of like their -- it's their checklist that they have to kind of work within. So I just want to make sure that everybody knows that I truly have heard residents and Members of all of these concerns, especially when it relates to seniors.
We have the Indigenous advisory board that's part of our health unit that has representatives from all our Indigenous governments. We work and we hear this from the -- I've heard it from the Council of Leaders. So all of you that have leaders that sit at the Council of Leaders, I've heard it from them as well, and I'm continuously having to give updates to them as well and just where we're at. So I just want to make sure that Members know that I'm committed to making sure that we're not just going to do band-aid things. We're going to put together a good proposal. I mean, that's the thing is the work that needs to be done needs to be done, and it's going to take some time. And, you know, I don't want to rush it because it needs to have all the pieces in place. Thank you, Mr. Chair.
Okay, thank you. Are there any further questions? Seeing none, please turn to page 218.
Health and Social Services, supplementary health benefits, operations expenditure summary, 2025-2026 Main Estimates, $24,964,000. Does the committee agree?
Agreed.
Thank you. There are additional information items on page 220 to 224. Are there any questions? Seeing no further questions. Okay, did Mackenzie Delta have your hand up? Oh, sorry. Okay, I'm going to go to the Member from Yellowknife North.
Thank you, Mr. Chair. So I've noticed in a couple of the health authorities -- well, specifically both NTHSSA and the Tlicho Community Services Agencies -- the amount allocated for administration, specifically, has really leapt dramatically this year as compared to last year and the year before. So with NTHSSA, we've gone from about $13 million to suddenly $18.5 million for administration. The TCSA, we've gone from -- well, two years ago, it was $783,000, and now we're up to $1.5 million. I know that we've talked earlier about cost increases related to the collective agreement.
Is that all this is, is that the costs of administration are soaring so much -- or spiking so much higher than the cost of everything else because of the collective agreement, or is there some other reason; are we adding positions or doing something new in administration in the health authorities? Thank you, Mr. Chair.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. Yes, a lot of it is within the health authority, especially NTHSSA, a big chunk of it is the collective agreement. But, however, as I mentioned before, this is the way health budget works. It's kind of -- so remember I was talking about that $14 million and we reallocated it, and so some of -- there's other funding that we have that we reallocated to historic deficits so those positions may have not come up before and now they're actually funded positions. So they're going in as funded positions, and I -- if I may, I mean, if you want the details of that, I can turn it over to the ADM.
Thank you. I'm going to go to the ADM.
Thank you, Mr. Chair. Just some detail at a high level is the funding that I spoke about before around the reallocation of the $15 million to health system pressures and the new money that got added to the budget for this 2025-2026 year, as well to address the health system pressures, are largely for things on administrative nature that have been creating deficits. For example, records management, those positions had been existing, but we had not put budget to them, so they had been creating deficit. Occupational health and safety staff, infection prevention and control, temporary accommodations for -- or accommodations for temporary staff. There had been lease costs that have also been historically contributing to the deficit for the authorities. Largely, those are administrative type things. So there is a good chunk of that money that's showing up in that administrative line. But the other piece of it is exactly as you described being the collective agreement increases for the staff that are considered administrative in nature as well. Thank you, Mr. Chair.
Thank you. I'm going to go to the Member from Yellowknife North.
Thank you, Mr. Chair. And I do think the public administrator has his work cut out for him in terms of sorting through the budgets if there's a lot of -- I'm sure there's way more things in there but, you know, that have certainly been done but unfunded, and there's sort of money shifting around. Without even changing service levels or what we're doing, there's already lots of shifting around of numbers in these budgets.
Okay. The only other sort of main topic I wanted to ask about, in terms of community clinics and health centres, can the Minister tell us how many communities do we have in the territory that doesn't even have a community health centre at all? Thank you, Mr. Chair.
Okay, thank you. I'll go to the Minister.
Thank you, Mr. Chair. Nine, we have nine health cabins in the Northwest Territories. Thank you.
Okay, thank you. I'll go to the Member from Yellowknife North.
Thank you, Mr. Chair. Is the department -- especially given that we're focusing on primary care and there's attempts at primary care reform, is the department looking at how we can try to put at least a community health nurse in every single community in the territory? Is that a goal that we have; is that something we're looking at? Thank you, Mr. Chair.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. What I can do right now is I will -- what I can say right now is is that we are doing a review of our model of care throughout our community health centres, and I've also asked them to look at how we are supporting those communities, those health cabin communities in some of those small communities and then ensuring that they're getting -- they're getting some care. But at this time right now, that -- during that review, you know, one of the things that I've always said in this House is that we need to make sure that our most vulnerable people, and especially in our small communities -- and that does include those communities that have health cabins and how we're supporting them. At this time, I won't commit to what kind of staffing will go into any of those positions because that would be a bigger conversation. Thank you.
Thank you. I'll go to the Member from Yellowknife North.
Thank you, Mr. Chair. I do look forward to that bigger conversation. I think it's quite urgent. Thank you.
Thank you. I'm going to go to the Member from the Deh Cho.
Thank you, Mr. Chair. Of those nine health cabins that you talked about -- that the Minister talked about, is one of them in Kakisa? Thank you.
Thank you. I'll go to the Minister.
Yes, that's correct.
Thank you. I'll go to the Member from the Deh Cho.
Is there one in Enterprise? Thank you.
Thank you. I'll go to the Minister.
I don't know if we consider it -- it's a satellite because their proximity to Hay River so if you want to consider it a -- but I don't -- the services we currently have, that would be considered one.
Okay, thank you. I'll go to the Deh Cho Member.
I don't know, but I think I asked you this -- I think I asked the Minister. Thank you, Mr. Chair. I think I asked the Minister about this before, but members from Kakisa have to travel out to either Fort Providence or Hay River, and Enterprise is probably to Hay River, because they don't have medical services in their little communities.
I guess I'm trying to figure out is how can they be compensated or if they have some kind of a health issue and they go to Hay River or Providence, is medical travel going to cover their cost to travel to the health centre in Fort Providence? Like, say, somebody got really sick in Kakisa and they had to drive to either Hay River or Fort Providence because they have no services in Kakisa, the person that administers -- I don't know, maybe it's just Tylenol, in Kakisa -- is not able to diagnose them him or anything or check them out or anything or -- so they make the decision to leave the community, does the person that takes care of the health cabin approve their travel to Hay River or to Fort Providence? Thank you.
