Debates of February 21, 2014 (day 16)

Thank you, Mr. Moses. We’re just going to circulate that motion.

Committee, the motion is in order. To the motion. Mr. Moses.

Thank you, Mr. Chairman. The committee is in strong support of the Mental Health and Addictions Action Plan; however, Members do feel that the portion allocated to this initiative and recommended the additional allocation of funding for the priorities in the action plan, and as I mentioned earlier, including but not limited to the detox facilities, after-care and enhanced mental health services. Also, to gain the judiciary’s confidence in the wellness courts, enhancements to existing mental health services will likely be required. Furthermore, this has been a big initiative of mine since joining the Assembly, and I’ve worked on it down to the point where we’re looking at addressing the Mental Health Act.

In the updated action plan for the addictions on mental health, 2014-2016, this committee, once again, is in strong support. We just want to make sure that there are sufficient funds available to address some of the needs of our mental health issues that we see in our communities across the Northwest Territories, and that is strongly supported by me and some of the committee members.

At this time, I would also just like to thank Members here for listening to recommendations made from the Standing Committee on Social Programs. We’ve been working on this ever since the beginning of the 17th Legislative Assembly, and we’ve always looked at supporting initiatives and supporting work that government has done through motions and through questions and how we deal with things in the House. I’d just like to thank the Members here today for at least acknowledging that committee is making recommendations for allocations within this budget to some of our biggest issues across the Northwest Territories. I just want to say thank you to all the Members for allowing us to bring these up in the House today. I’m not sure if any other Members will speak to the motion.

Thank you, Mr. Moses. To the motion. I have Mr. Yakeleya.

Thank you, Mr. Chair. I do want to thank Mr. Moses for bringing this motion up, and I also wanted to say to government, you have come a long way in the different areas of how we deal with mental health, addictions, drugs and alcohol and moving away from the residential treatment programs and now to listening to people on-the-land treatment programs, mobile treatment and just new initiatives that we’re taking on. It’s been a while since we’ve had this type of new shift in the making of healthy communities as to our priorities and goals. This motion here speaks to support this. We’re looking for money inside.

Last year the Northwest Territories Liquor Commission made $24 million profit off of liquor in the Northwest Territories. They bought about $47 million, $45 million worth of booze, and after all the expenses they have a profit sitting there of $24 million. We have, through Bill 24, had some quite intensive, emotional, strong statements of people in the Sahtu just on the effects of alcohol and the things that they needed to do in the community to deal with the evils of alcohol abuse. The motion speaks to maybe looking at the Liquor Commission. I know there’s money that goes into general revenue and then goes to all the departments. We passed a motion last year to have a percentage of the profits from the liquor sales go directly to a program in the communities to fight alcohol abuse, and that motion hasn’t even been acknowledged or been responded to looking at what we want on this side here. I would say that if the government could look at finding the additional dollars using the Liquor Revolving Fund as a means to say yes, we could look at something like this, other than to say, well, it goes into general revenues and it cuts right across the whole board.

Let’s do something symbolic, something that says we’re buying $47 million of liquor. We could at least put some money, 10 percent of that percentage directly into the communities and in support of community members. Let’s change some things. Let’s do things differently. Otherwise, you’re going to hear we had money, $86 million. This is a specific area of profit we want to go into even though alcohol touches many other areas. I would strongly urge Cabinet to think about this and to look at this and really consider when you’re looking at this motion, give us a good reason why you’re going to be voting against this and not supporting this motion. If you’re not going to support this, give us a good reason as to why you’re not supporting this motion of $2 million. We buy $47 million worth of booze for the Northwest Territories people. We make a profit of $24 million. At least a percentage should go back to the communities. We have heard from the Sahtu, five communities, through Social Programs. We know of the pain they spoke of and the alcohol abuse and addiction. I do applaud them on the new direction we’re going in, but we need to ensure that this type of funding gets into the communities. We’ve lost enough young ones and enough people through this addiction and we’re looking for something challenging.

I want to thank Mr. Moses for bringing this up and for the Members for listening to our people in the Sahtu on the recommendations we had on Bill 24, which is outside the legislation we’re going through. I want to leave it at that, Mr. Chair.

Thank you, Mr. Yakeleya. Mr. Menicoche.

Thank you very much, Mr. Chair. Regretfully, I can’t support this motion on the addition to our budget. We all heard on this side of the House how we’ll be faced with up to a $30 million reduction in our budget and we have to work hard after we pass this budget to do it.

I’m concerned because these reductions are coming and we want to add more money to the budget. I would like to say that sometimes the MLAs’ jobs are not about what we’re getting or what we’re adding, it’s what we hang on to. That exercise is coming, Mr. Chair.

For example, the reduction of half a position, point five of a position, or the reduction of programming dollars as small as $10,000 has serious effects in small and remote communities. Those resources are very, very hard to come by. Even though they’re small, they have a big impact in the small communities and I represent six of them.

Members spoke about the lack of strategy, but there is a new Aboriginal Wellness Strategy in office that is going to be established in this upcoming budget.

With that alone, I can’t support any addition to the budget knowing we have cutbacks coming up. I will be voting against the motion. Thank you.

Thank you, Mr. Yakeleya. Ms. Bisaro.

Thank you, Mr. Chair. I just want to suggest that the motion can be read in a different manner than what Mr. Menicoche has interpreted it as. It recommends an additional allocation in the fiscal year of $2 million; however, it does not say it has to be new money. The committee is simply suggesting that we need to put a larger focus on mental health and addictions priorities and on actions that address mental health and addictions. It doesn’t necessarily have to be new money. There are lots of things that the department wants to do, but if the department so chooses, they can take money from within and allocate more money to mental health and addictions than what is already established in the 2014-15 budget. Thank you.

Thank you, Ms. Bisaro. Minister Abernethy.

Thank you, Mr. Chair. I’ll start off with the financial bit. We do have a $30 million reduction exercise coming in front of us the next couple of years to make up some of the financial shortfalls that we are aware of. We can never ignore that there are those challenges in front of us.

Having said that, this government, with support of committee, has done a significant amount of work on mental health and addictions. We have options in front of our residents today that did not exist previously. A resident who requires detox can go to one of our hospitals and receive detox. Withdrawal management is an issue but we try to find ways to address that. Right now, if somebody needs a medical detox, they can go to one of our hospitals and get that detox.

We have the wellness courts. It’s in the Justice budget. The integrated case management around putting in wellness courts is in that budget. We are moving forward with wellness courts and we have support from the judiciary who are actively involved and engaged. This program will need to be grown over time as we enhance and expand the services that are available, but we have to start somewhere and we have to manage that growth as opposed to jump in without being ready. It will build over time.

In 2013-14 we put in an additional $1.145 million into mental health and addictions for youth addictions, prevention and promotion, service promotion, some case management, some pre-feasibility work for on-the-land programs, youth on-the-land programs. We are running free pilots this year. Development of youth and detox models, which are underway; Stanton Dalhousie psychiatry telehealth and stronger standards of quality assurance.

One of the Members said why not support, we need a good reason why Cabinet will not support this. The reason is we are investing a significant amount of money, but we could do better with the dollars that we have. We need to enhance our programs and redesign our programs so they meet the needs of our residents. To that end, we have done things already that are making a big difference like streamlining a referral process. An individual now needs treatment in the Northwest Territories can go through a referral process that is 24 hours. We are doing more with less. In this case, more with the same. We can continue to find improvements in our system that will allow us to get maximum benefit for the dollars we have. Throwing dollars at it won’t necessarily solve the problem if we know what we’re trying to fix, and in the department we have lots of opportunity to enhance our programing without dollars by streamlining and rethinking how we do business.

In this budget we’re adding $900,000 for on-the-land programming, which is something new this government hasn’t done before. We are doing good work, and together with the Regular Members, we continue to do more good work.

So there are a number of reasons why throwing $2 million at a problem is not necessarily the best way to go when we already have $6 billion that we’re spending on programs and services for the Government of the Northwest Territories. It’s more important that we do better with the dollars we have to serve the needs of our residents.

Also, we’re engaging communities in way that we haven’t in the past. We have an Aboriginal health and community wellness division that has worked with every community to develop community wellness plans where communities are leading in their wellness. Money is coming from the federal government through us to them so that they can take actions and initiatives. Every one of the communities has identified priorities for work that they want to do.

So there’s a lot happening. Will it be successful? Some of it will take years for sure to know whether it’s successful, but good things are happening and I think we are better positioned, recognizing our fiscal realities, to use the dollars we have and make sure we’re getting maximum benefit as opposed to piling new dollars on top and expecting that throwing money at the problem is going to solve the problem. Redesign, rethinking, working hard, that’s going to solve the problem in the long term. We won’t be supporting this motion.

Thank you, Minister Abernethy. Minister Miltenberger.

Thank you, Mr. Chairman. Just very quickly, as legislators we have responsibility for the whole 360 degree range of programs and services that we have to deliver as a government. The budget we have presented to you spends every dollar that we have, plus we’re borrowing, all for good programs.

The intent of the motion is not one anyone argues with. The need is one that we know there are still challenges, but we also have to live within our fiscal means. We are in a choice business. It is too easy for some Members to say if we choose, we can just move $2 million somewhere else in a budget that is fully subscribed to, in a process that has been before this House for seven months when we know in cases where we have done that or are suggesting that. For example, even tapping into some of the surpluses that education bodies have, there are concerns being voiced that we shouldn’t be doing that. So we have a budget that’s fully subscribed to and I want to remind folks that we have to make choices and this is one of those choices. Thank you.

Thank you, Minister Miltenberger. To the motion. Mr. Bromley.

Thank you, Mr. Chair. That’s, frankly, gobbledegook that this Cabinet has the power to move around money and reallocate it. We’ve asked a number of times for the Minister of Finance to give us clarity on where that’s possible from his perspective. So, yes, I think committee members are certainly well aligned with reasonableness with this proposal. They may not agree with it, but totally in line. Mahsi.

Thank you, Mr. Bromley. To the motion.

Question.

Question has been called. The motion is defeated.

---Defeated

Committee we are in 8-31 and continuing on with questions on page 8-31, I have Mr. Blake.

Finally, Mr. Chair, thank you. I have some questions for the Minister from a while back, but I just wanted to raise a concern from the communities that long-term care is a huge need in the communities of Aklavik, Fort McPherson and Tsiigehtchic. I realize that we do have a facility in Inuvik, but as I mentioned a number of times, it only holds a small amount of people, roughly 20 people at the most, and with over 350 people alone in my riding, not to mention Nunakput and the Sahtu – there are members that stay there from those regions – it’s quite clear that that facility can’t take all who need full-time care. As we move forward in this government, it’s time to put back those facilities into those communities and offer those services. Whether it’s a partnership with the communities to provide long-term care, I suggest that we need to move into that area and I’d like to hear what the Minister has to say. Thank you.

Thank you, Mr. Blake. Minister Abernethy.

Thank you, Mr. Chair. Long-term care would be under territorial services as opposed to community services, but I understand the Member’s point. Obviously, with an aging population, this is something that we all need to be conscious and aware of, especially how that’s going to roll out and affect communities in the long-term.

We have the continuing care report that was distributed to Members early this week highlighting where we are now and where we need to go. That’s going to help us inform our Aging in Place Strategy. So, as we move forward with this Aging in Place Strategy we’ll start to identify what we can do better, where to help individuals in their communities, in their regions and within the Territories as they age.

I do know that the NWT Housing Corp has, in their plan, some independent living facilities for elders throughout the Northwest Territories and they’re redoing the Joe Greenland in Aklavik. I think there might be another one in the region, but you really need to confirm that with the Minister of the NWT Housing Corp.

So I hear you, we are doing work, we will be able to have informed discussions once we get this report out and start having discussions around the Aging in Place to make sure that your residents have the services they need in the regions, in the communities where they’re needed. Thank you.

I know last year we had a commitment that the Minister would work with NWT Housing to provide services, whether it’s someone coming in during the day to work with the elders to do exercising programs or make sure that they all have meals. Is the Minister going to follow through? Thank you.

The two departments have been working together. The new facilities have been designed so there’s a day program room area where different programs can be delivered in the communities where those independent or assisted living homes are going to be located. As those programs roll out, authorities will work with the communities to make sure that our staff are able to provide the services and if it means increased staff, we’ll certainly have to have those discussions at that time.

Thank you, Mr. Abernethy. Committee, we’re on 8-31 and continuing with questions, I have Mr. Bromley.

Thank you, Mr. Chair. I wanted to follow up a little bit on the mental health and addictions, obviously a big priority for us and I know it’s a priority for the Minister. Specifically with respect to the wellness court efforts, I think I’ve said before that I think this is possibly the best single effort or opportunity we have to make progress in the mental health areas. So I’m wondering if the Minister can point out what expenditures here, what dollars here are going towards ensuring the mental health services are there for the mental health court time,

I might point out that we’ve been dabbling and dithering in this area for years while every other jurisdiction in Canada has moved forward with this. I think it was years ago the Minister visited the Yukon and now we’re talking about some tiny little pilot project that just is underfunded and clearly not meeting the opportunity that we have here. So I’d appreciate at least knowing what modest dollars the Minister is committing on this page to the wellness court preparations. Mahsi.

Thank you, Mr. Bromley. Minister Abernethy.

Thank you, Mr. Chair. I and the Department of Health and Social Services are clearly supporters of the concept of a wellness court and Health and Social Services has been an active supporter of the concept of a wellness court and it remains a priority as we move forward, and it’s also important to helping address things like the addictions and mental health in the Northwest Territories. The role of the health and social services system is to ensure that mental health services are available. With respect to the wellness court, which will give confidence to the judiciary in the effectiveness of a wellness court and I do know that the judiciary are actively involved in the wellness court as we move forward.

The Member keeps asking what money have we put in, what money have we put into this. I think a 0.5 PY, but that really doesn’t do what the department is providing around this service as Justice. We do have social workers who will be involved, we do have other professionals who will be involved, and it doesn’t necessarily require creating a whole bunch of new positions or dumping a whole bunch of money. The biggest part of the budget for the wellness court is actually coming from the Department of Justice, but Health and Social Services will continue to be an active partner utilizing the resources that we have today. Once again, it’s about doing better with what we have and making sure that the services we’re providing meet the needs, including the needs of a wellness court.

For years we’ve heard how we have to bump up our mental health services and resources in order to get that wellness court and now we’re saying no, no, it’s all up to Justice to come up with the bucks for it. It just makes sense to me that the major part needs to be mental health services. So I guess I heard 0.5, a half a person here is what the Minister is committing to this wellness court business at some point in time perhaps. I mean, this is shameful after years of discussions and the passing of motions in this House. When will this mental health and wellness court actually happen on a pilot basis, and can the Minister describe the role Health and Social Services will play in it?

I appreciate the Member’s passion for wellness courts and it’s something that I obviously support as well. But at the end of the day, a wellness court is dependent on the support of the judiciary, so we obviously have to make sure that the judiciary are comfortable with the programs and services that we provide.

There is significant money going into the wellness court in ’14-15. Eight hundred seven thousand dollars has been identified within the Department of Justice budget. It is in the Department of Justice budget but it is a collaborative effort and it’s taking the activities and the work of many departments to make this a reality, but the dollars did need to be located somewhere. So I don’t necessarily agree with the Member’s assessment of the situation that this department isn’t contributing, because we do have our people on the ground participating and meeting with the committee that’s put together.

I do know that the Department of Justice will be approaching the Members of the House to provide a comprehensive presentation on the wellness court and the services that are available under that, and it may be beneficial to maybe go to Mr. Ramsay to have him talk a little bit about the wellness court and what’s happening and the steps we’re taking. But we are making progress and we will see a wellness court in this fiscal year, providing that the judiciary does support.

Thank you, Minister Abernethy. We’ll go to Minister Ramsay.

Thank you, Mr. Chairman. We’re moving forward with the plans for wellness court. We will be in front of committee for a detailed presentation on Monday, February 24th. So on Monday we’ll be in front of the Standing Committee on Social Programs. I look forward to Members’ input on our plans thus far. Our anticipation is to have the wellness court up and running this year. It will happen. We’ve got some funding to see that happen and we want to get Members’ feedback on Monday on our progress to date. Thank you.

Thank you, Minister Ramsay. Mr. Bromley.

Thank you, Mr. Chair. Thanks for that update and I’ll look forward to approving those dollars when we get to Justice.

We’ve always heard how this has to be an integrated program between Health and Social Services and Justice, so I would hope and assume that both Ministers will be at that briefing on the 24th. That’s departing from the budget here. I’ll just throw that out as a comment. Thank you. That’s all I have, Mr. Chair.

Thank you, Mr. Bromley. We’ll treat that as a comment. Thank you. Page 8-31, activity summary, community programs, operations expenditure summary, $99.116 million. Does committee agree?

Agreed.

Thank you, committee. Pages 8-32 and 8-33 are combined. Ms. Bisaro.

Thanks, Mr. Chair. I just have a question here on 8-33 under family violence funding. The Family Violence Coalition a while ago put forward 19 recommendations. I know the Minister has said that the Health department is working on them.

Is the Family Violence Coalition money in this budget or is it in another department? I can never remember quite where it is. If it is in here, is there a focus on the 19 recommendations from the Family Violence Coalition? Thank you.

Thank you, Ms. Bisaro. Minister Abernethy.

Thank you, Mr. Chair. The dollars identified here are the dollars that are provided to the authorities to provide services in regions and communities.

Thank you, Minister Abernethy. Committee, we are on 8-32 and 8-33. Mr. Bromley.

Thank you, Mr. Chair. I see a number of supports here in the area of child and family services. I know the Minister is firm in support of the principle of keeping children in the homes with their families to the extent possible within the obvious guidelines of safety and whatnot. Can he tell me what progress we’re making? What proportion of children are we putting in care these days outside the homes versus figuring out a way to keep them in the homes? Thank you.

Thank you, Mr. Bromley. Minister Abernethy.

Mr. Chair, there are some statistics in the annual report. On page 29 it actually refers to the percentage of children receiving services in their home community under the Child and Family Services Act, and the baseline on that is 80 percent. For 2012-13 we had set a target of 83 percent, but in that same fiscal year we actually succeeded to hit levels of 87.5 percent. That information is in the annual report.

That sounds like good progress to me. I’ll try to score a few minutes to look at that report.

Just on page 33, the non-government organizations residential care programs and services related to addictions, mental health, disabilities and chronic illnesses, quite a decline over the last few years. Does the Minister know why this is happening? I noticed quite a difference between the main estimates and the revised estimate last year or this fiscal year. Is there not an uptake from our community organizations here? If that’s the case, $2.9 million approved, $835,000 in expenditures… This is quite a drop and I’m wondering if there is less uptake because of capacity. Is that something the Minister is looking into or would look into to try and give these organizations the support they need to deliver these sorts of programs? Thank you.

One of the main reasons for the reduction here is the dollars from here, some of these dollars were the dollars that went to Nats’ejee K’eh and we’re not providing that in the same way. Those dollars have now been reverted into the department. We’re using them to fund the four facilities, or portions of the four facilities that we’re contracting with in the South plus the mobile treatment program that we’re exploring with Poundmaker’s and some of the other programs related to mental health and addictions.

Thank you, Minister Abernethy. Committee, we’re on 8-32 and 8-33, activity summary, community programs, grants and contributions, $73.704 million. Does committee agree?

Agreed.

Thank you, committee. Page 8-34, information item, community programs, active positions. Any questions?

Agreed.

Thank you, committee. Page 8-35, information item, details of funding allocated to health and social service authorities. Any questions? Ms. Bisaro.