EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
Also, if the client is medically incapacitated, the escort would assist with the travelling. So let’s say if the client is wheelchair-bound or disabled or incapacitated in any way, they would help them during the plane journey, during the journey to the medical centre.
Also, if the client has a need for a legal consent by a parent or guardian, then we would expect that the escort who is accompanying the young child would be able to provide that legal consent.
Also, if the escort is going to be participating in the client treatment program, then the escort would be able to take instruction from the physicians who are providing the care for the client. So they would have to be able to take that instruction so that they can provide that treatment when they return home.
I thank Ms. Voth for that description.
One of the issues that we have in Sanikiluaq is that we share the boarding home in Winnipeg with the people of the Kivalliq.
There’s quite a difference in the dialects between the two regions.
It seems that a lot of times, translation services are difficult in Winnipeg because there are mostly people from the Kivalliq who work at the Inuit centre and they can’t provide the translation services accurately.
So I’m just wondering: is there anything that your department is doing to help with the translation services that are required in the boarding home in Winnipeg?
I thank Mr. Rumbolt for raising that concern with us.
My understanding is that the department is looking for a clerk interpreter for that boarding home. The issue would be trying to find an individual who would be willing to relocate and reside in Winnipeg to perform that job.
When an escort goes out of the community with a patient and the patient is admitted to the hospital and required to stay there for a period of time, the escort is also required to stay at the hospital. There are times when they have to sleep on chairs or sofas or whatever they can find a place to put their head.
Is there any support provided at all for escorts who have to stay at the hospitals?
I’ll ask Ms. Voth to answer that question.
To rephrase that backward, my understanding is that you’re asking about possible care gaps in the south and that is an issue that we have recognized and we’re under discussions with our referral partners in the south.
So that would be an escort providing care above and beyond what we would expect an escort to be providing. So as part of the medical travel review, we are taking a look as well and having discussions with our referral partners.
So that would be, for example, OHSNI in Ottawa and the referral partners in Winnipeg and talking about identifying what the care gaps are and what the possible solutions are.
Chairman (interpretation): Thank you, Ms. Voth. Mr. Rumbolt.
I’m not sure if she answered my question correctly or not.
My question is primarily about the escorts themselves.
Maybe I should ask: are the escorts required to stay at the hospital with the patient while they’re admitted at the hospital?
Without knowing the circumstances, it is difficult to answer the question. If the individual is in the hospital, we don’t think we would normally expect the escort to stay in the hospital around the clock while the patient is in the care of the hospital.
A slightly different question. A couple of months ago, I wrote a letter to the minister with concerns about a lady who was breastfeeding an infant. She was required to go out on medical treatment and she was denied the opportunity to take her baby along with her because she was breastfeeding.
In the policy, it states that if a person is breastfeeding, they are able to take their infant child with them if they can find someone to provide care for their child while they are at their appointments.
I appreciate the concern that Mr. Rumbolt has shown for this lady and I apologize for that happening.
I’m going to ask my deputy to respond to that question.
Mr. Ma: Thank you, Mr. Chairman. I do recall the circumstance that you’re speaking about.
I have to actually go back and look at why it was denied, but I was actually the one who denied it.
There were some other circumstances, if my memory serves me correctly. Perhaps we could have a conversation around that later.
Chairman (interpretation): Thank you, Mr. Ma. Mr. Rumbolt.
I’ll change gears a little bit again.
In our communities, our health centres have one or two vehicles at their disposal.
Can you clearly describe the purpose of the vehicles in the communities for the health centres?
Chairman (interpretation): Thank you, Mr. Rumbolt. Minister Peterson.
Deputy Ma will answer that question.
Most of the vehicles we have in the communities are for what we call home care services. In other words, we have a nurse of some type or one does not necessarily to have the nurse, but we have somebody go to a home to provide services to an individual.
I think what the member is referring is a conversation we had with my former minister and I when we were in Sanikiluaq in May.
I believe the community was looking for some sort of transportation to the airport, if I recall. My minister and I were also at a meeting today with the Baffin mayors and that topic also rose there.
It is an area that we’re looking at.
What I will reiterate is that currently, this is not covered through Non-Insured Health Benefits, but we are having, hopefully, maybe a fruitful discussion at some point in time that we can report back on. At this point, there is not much movement.
Yes, part of the issue is getting patients back and forth from the airport when they are travelling to Winnipeg for medical, but another part of the problem is that in smaller communities, there is not a lot of modes of transportation, especially after hours, even during the day for elderly patients who want to get to and from the health centre.
I know it’s a stress on health centre staff and they’re not required to pick people up after hours.
I’m just wondering if there’s anything that you could see in the future that your government will be doing to provide maybe an ambulance service in the communities.
Hon. Keith Peterson: Thank you, Mr. Chairman. I thank Mr. Rumbolt for raising the concern.
There is only one ambulance service in Nunavut and I believe it’s here in the city of Iqaluit. In the other couple of communities, it’s simply called ground transportation.
There are issues with liability and risk management when you provide ambulance service because the personnel have to be highly qualified and trained to provide that service.
As the deputy said, we did hear this concern at the mayors’ meeting this morning and we have heard it in the past, so we are looking into it. In negotiations with NIHB, we hopefully can have some good news at some point. Thank you, Mr. Chairman.
Chairman (interpretation): Thank you, Minister Peterson. Mr. Tapardjuk.
Mr. Tapardjuk (interpretation): Thank you, Mr. Chairman. I would like to welcome the minister and his officials. The questions I had were already asked by my colleague sitting beside me, so we will expect changes within the policy for transportation to the airport.
Indeed, some patients have no capability to reach the airport, particularly those without access to vehicles.
Mr. Chairman, what I want to ask about is with respect to patients requiring home care, specifically elderly patients. This falls within home care and community care.
Treatment is identified in this line item for fiscal year 2012-13. It appears unchanged from the previous year.
Mr. Chairman, let me question the witnesses thusly. With respect to those who have to provide care for patients with mobility issues or those ravaged by old age that require home care and general housecleaning duties, are the housecleaners or home care assistants who provide this care required to speak English?
Chairman (interpretation): Thank you, Mr. Tapardjuk. Minister Peterson.
Hon. Keith Peterson: Thank you, Mr. Chairman. I thank Mr. Tapardjuk for the question. It’s my understanding they can speak English or Inuktitut or Inuinnaqtun or any combination to provide home care service.
Yes, I had wanted to raise this question, which I had asked quite some time ago when I first became a legislator, when people were removed for their inability to speak English and they hired English-speaking workers instead. The patients requiring home care, being elderly Inuit in most cases, usually prefer their own language. In the past, they were provided care and communication primarily in Inuktitut.
However, due to this requirement to have English-speaking employees, this aspect of home care provision has fallen on the wayside.
Additionally, the Nunavut government has now enacted legislation for the territorial official languages, recognizing Inuktitut, French, and English. This applies also to the operations of the government. Is the previous requirement still in place within the Department of Health and Social Services?
I refer to the past requirement for any person providing home care to be able to converse in English. Is this true?
I thank Mr. Tapardjuk for the question. A little bit of debate down here at this table, but I think they would have to perhaps be bilingual. I would certainly support that an elder who is getting home care should be able to communicate with the person who is providing home care services for them.
Mr. Tapardjuk (interpretation): Thank you, Mr. Chairman. I would like to ask who makes these decisions related to these employees. Is it the human resources department that hires the home care people or is it the administrators at the health centre?
Who makes the decision for the hiring of the home care workers? Who makes the final decision?
There is a supervisor in each community who is responsible for home care and that individual would hire the home care workers.
The reason is that this was a cause of concern in the past, particularly for patients requiring home care, with some past registrants of complaints on the matter having passed on due to old age.
Many patients requiring home care are quite elderly and they prefer to have home care workers closer to their generation who are able to speak to them in their own language. The only way for these patients to receive proper care is to have their complaints or concerns addressed by workers who understand the language.
When a worker is a younger person with a limited lexicon, I don’t think they can understand the elderly who speak traditional Inuktitut.
This sometimes causes misunderstandings and problems in providing proper care. The home care worker provides care according to their preferences and not the patient’s preference, and the patient is seemingly forgotten.
I believe that to be the case all too often. This is merely a comment.
Let me raise this question now. Did I understand the minister when he stated that it would be best if the home care provider was bilingual in Inuktitut and English? The minister also seemed to state that the home care workers could be unilingual Inuit with no fluency in English.
Did I understand this to be the case? Let me ask that question if I may, Mr. Chairman.
I thank Mr. Tapardjuk for asking for clarification.
It would likely have to be both languages because they would have to be able to communicate with the elder who wants to speak to them in their own dialect, but then they would have to communicate with the supervisor, who may not speak that dialect.
In most cases, we do try to allow the persons seeking home care to pick the individual who will provide home care for them.
Yes, this is indeed good news to hear. I believe that the government shouldn’t be so fixated on the requirement to improve this situation.
Indeed, in that past, it caused a lot of problems when the workers who were unilingual were removed and replaced with English-speaking workers.
The patient was forgotten entirely, all in deference to the preferences of the supervisor who required communication in English only.
This was not a good situation.
I understand this matter will be examined.
Mr. Chairman, I would like to ask this question at this time. The business plan speaks to a review on the types of services that are required and how many employees are required, as well as the hours of work that will be subjected to this review. This review looks at the employees that need assistance or if it’s too low, then it will be reviewed further.
In looking at the figures listed in the appropriation bill for 2011-12, the amount was $7,247,000. For 2012-13, 2013-14, and 2014-15, the figure is now $7,283,000, which would be the amounts used annually for home care and community care.
These indicate that the budgets are not increasing, so I gather that other communities haven’t requested home care funding.
Can I get that clarified first? The figures look unchanged over these years that I mentioned for our future funding.
So I would like to ask what the reasons are for the funding remaining the same.
The figures are listed on page 139 of the business plan.
The amount I’m looking at has actually increased a little bit. If home care services are required and we run into monetary difficulties, if we need more home care workers, we would hire them because that’s important.
Just to give you an idea, between April 1 and December 31, 2011, there were 1,269 Nunavummiut who received home care services, so it is a very important function of our department.
If someone requires home care services, we would provide that. If we didn’t have a home care worker available, we would hire someone casual.
I believe we’re working with Nunavut Arctic College. There is a five-year education training program that we are working with Arctic College to train people to be home care workers in their communities.
There is an increase of $2 million for community health centres in 2012-13.
Are you going to be increasing the number of nurses or health professionals?
Is that why you’re asking for a $2 million increase? I would like to know what that additional $2 million is going to be used for.
I apologize for the delay. There is a lot of paper to sift through down here.
Yes, the amounts would be for travel and transportation, purchase services, materials, and supplies for the community health centres.
Are you done, Mr. Tapardjuk?
In reference to your business plan, a priority for 2012-13 is to “Undertake a review of the Mental Health Act.” Also a noted priority for 2013-14 is “Based on the review, determine whether legislative amendments would be necessary for the Mental Health Act.”
My question for the hon. minister and the departmental officials is: what specific aspects of the current legislation will be focused on during the review?
I think I mentioned yesterday to one of the other members that we’re in the very early stages of looking into that.
The review would take into consideration cultural relevance, compliance with existing laws, and consistency with similar legislation in other provinces and territories.
Similarly to my colleague, Mr. Tapardjuk, in regard to the business plan on page 139 under home care and community care, one of the areas identified is disability.
The priority here is indicating, and I quote, “The objective is to preserve and maximize an individual’s ability to remain independent in the community through case management, nursing, and personal care.
This area supports and strengthens family and community involvement in the delivery of care.”
Mr. Chairman, I want to ask in regard to disabilities. Your priorities indicate that in 2011-12, the money requested at the time was $7.24 million and in 2012-13, they’re requesting $7,283,000. It’s up by 36,000 kilometres, not kilometres.
It has been a long day. $36,000. It has been a long day.
Are there any indicators or formal requests by groups or committees to increase the services by possibly increasing the dollars that we contribute?
Yes, I agree, it has been a long day.
We’re not aware of any requests from any groups to increase the level of funding.
As the hon. minister and his officials are aware, on behalf of constituents, I am to bring formal documentation in order to address the issue, but for the record, the question that I would like to ask is in regard to Nunavut health care as beneficiaries and access to non-insured health benefits.
Some constituents have had referrals for specialized care. Sometimes when their specialized care had been referred, it has gone through the proper process of being approved. Sometimes there is miscommunication or people not sharing information well enough.
I wanted to ask the department: who makes the decisions for referred specialized care, for example, maybe an audiologist or braces?
I thank Mr. Aupaluktuq for asking that question.
The braces would fall under dental services, which is an NIHB service, and that referral process does reside in Ottawa.
So the referral would go down to Ottawa and go before a board and would be approved, and then the results of the approval would come back to us.
If that process has been followed and adhered to by the clients, how can they appeal further to get administration and to deal with matters that are urgently needed, such as access to specialized care?
We do have a Non-Insured Health Benefits office in Rankin Inlet and they do take a look at special circumstances and if there has been some sort of misunderstanding or something hasn’t been communicated very well to the board that decides on whether they are approved or not, then they can actually look after that.
So that would be the Rankin Inlet office, the Non-Insured Health Benefits office.
On my list, there are four more names.
Ms. Ell (interpretation): Thank you, Mr. Chairman. I also thank the minister for appearing before the committee along with his officials, both of whom are residents in my riding. I want to welcome the officials.
Since we have a public government in Nunavut, it has to represent all residents living in the territory.
During my campaigning, I often heard concerns from residents, at least here in Iqaluit. Since we have an ambulance service available that handles this service, it is a little easier at least for the Inuit as they can get funding through NIHB for the provision of this service if we were to call in an emergency. This can be clarified later on.
Additionally, government employees have the option of their employment insurance, if they have one.
However, some people with low income, such as elders who only receive an elder’s pension, as well as people on social assistance or those who are not employed by the government, as well as those people who are unemployed, are subject to this.
I was informed about two main incidents, with one couple where the partner suffered a heart attack, but no one called the ambulance service as their assumption was that this service would be too expensive.
I would like some clarification about exactly how this system is set up as it applies to our residents. Let me ask that question for clarification first.
Hon. Keith Peterson: Thank you, Mr. Chairman. I thank Ms. Ell for the very good question.
Chairman (interpretation): Thank you, Minister Peterson. Ms. Voth.
I don’t think there is any jurisdiction in Canada that does insure the emergency ambulance service from the home to the place that health care services are provided. The Non-Insured Health Benefits does provide it to land claims beneficiaries. Most working people do have it under third party insurance, but there are some people who do fall through the cracks, who don’t have insurance, and are not a land claims beneficiary.
There would be an income test. There is a possibility for an income test, so that would be considered to be a social services client.
If they are eligible for extended health benefits or is a social services client, then that would covered as well.
I thank you for the clarification and I will revisit this matter with you at another time at your offices.
The other matter is in respect to patients who have to travel south for medical travel. From my perspective, they seem to follow this procedure in the south.
So I would first like clarification on whether or not the boarding homes are specifically just for Inuit. Can you shed light on this?
Hon. Keith Peterson: Thank you, Mr. Chairman. I thank Ms. Ell for that question as well.
Ms. Voth will answer that.
Yes, the boarding homes are geared for the land claims beneficiaries or Inuit.
Chairman (interpretation): Thank you, Ms. Voth. Ms. Ell.
Ms. Ell: Thank you, Mr. Chairman. Can you give me an indication if that is because the patient is being paid by the NIHB or is it because the people who own it have a rule that only Inuit will stay there? Can you explain how the actual process is in place right now?
Chairman (interpretation): Thank you, Ms. Ell. Minister Peterson.
Hon. Keith Peterson: Thank you, Mr. Chairman. I thank Ms. Ell for that question. Debora Voth will answer that question.
It is the accommodations, ground transportation, and other benefits that are provided when you are in a southern boarding home. They are not an insured service, so they do fall under the Non-Insured Health Benefits package for a land claims beneficiary. The boarding homes are set up for land claims beneficiaries because they are the special groups that are insured for accommodations and ground transportation in the south.
Thank you for that. The question then is if, hypothetically, the Nunavut government were to pay a portion. If a certain portion of funds is small because the population that would want to stay there that speak Inuktitut have been long-term residents in Nunavut are a minority that may want to stay there, that are not beneficiaries… .
Would they, down the road, possibly be able to stay there, other than NIHB, if they were paid by other means to be there? As you are saying, right now, NIHB is paying for the Inuit who stay there. The people who own the building are perhaps just interested in getting their funds one way or another for the accommodation.
Am I correct in saying that, Mr. Chairman?
It’s a good question and we can take that under consideration as part of our client travel review. Thank you, Mr. Chairman.
Chairman (interpretation): Thank you, Minister Peterson. Ms. Ell.
The purpose for raising that matter is when Inuit patients are boarding at the home, many patients question why certain people are allowed to board at the home, especially if they’re not Inuit. They wonder why the policy is not being adhered to and they note that it is not being applied consistently. If it was completely clear and written out as to who can stay at the boarding home in Ottawa or if all residents of Nunavut can board there, it should be listed.
However, if the procedure being followed is what is required, then it should be written down as that would answer many questions raised by patients.
Mr. Chairman, I would like to move to another subject related to boarding homes. The questions I raised earlier this week during question period were with respect to the planned Kitikmeot treatment facility for alcohol and drug treatment. Based on the responses I heard, I believe that this pilot project was only scheduled for a one-month trial period.
I wonder if this matter can be explained further since I question whether they will be able to make recommendations as to the usefulness of this facility based on only one month of operation.
Hon. Keith Peterson: Thank you, Mr. Chairman. I thank Ms. Ell for the question. Yes, it’s a 28-day program and it will be in Cambridge Bay.
Because it’s a pilot, we want to design the program. There are people employed. Different organizations will be involved and different people involved in helping set it up, and then deliver it.
We want to have some time to collect information during the training program and then after the program to see how it worked when people return to their communities and then to their homes.
We will then monitor the success of the program.
Thank you for that, minister.
Then the question is: do you believe 28 days is enough to do an addictions treatment?
That’s a good question. I’m familiar from the past that the wellness centre in Cambridge Bay had a 28-day program.
The issue became after the program ended. A lot of the individuals didn’t receive support back in their communities or in their homes.