EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
Hon. Kelvin Ng: Mr. Speaker, I give notice that on Monday, May the 13th, I will move that Bill 11, An Act to Amend the Legislative Assembly and Executive Council Act be read for the fist time.
I seek unanimous consent to waive Rule 45 (1), so that Bill 11 can be read for the first time.
Speaker: The minister is seeking unanimous consent to waive Rule 45 (1) so that Bill 11 can have first reading today.
Bill 11 – An Act to Amend the Legislative Assembly and Executive Council Act – First Reading
Mr. Speaker, I move, seconded by the honourable member for Baker Lake, that Bill 11, An Act to Amend the Legislative Assembly and Executive Council Act, be read for the first time.
All those in favour? All those in favour?
The motion is carried and Bill 11 has had first reading.
I seek consent to allow the second reading of Bill 11.
Speaker: The minister is seeking consent to waive Rule 62 (1), so that Bill 11 can have second reading today.
Bill 11 – An Act to Amend the Legislative Assembly and Executive Council Act – Second Reading
Mr. Speaker, I move, seconded by the honourable member for Baker Lake that Bill 11, An Act to Amend the Legislative Assembly and Executive Council Act be read for the second time.
This bill amends the Legislative Assembly and Executive Council Act to bring certain sections of the act into force on March 6, 2002 and to make minor technical amendments.
I seek unanimous consent to waive Rule 67(2) and ask that Bill 11 be ordered directly into the Committee of the Whole.
The minister is seeking unanimous consent to waive Rule 67(2) so that Bill 11 can proceed directly to the Committee of the Whole.
There are no nays accordingly Bill 11 is ordered to the Committee of the Whole.
Consideration in Committee of the Whole of Bill and Other Matters; Bill 2, 3, 4, 5, 6, and Bill 11, Minister’s Statement 020 - 1(6).
In accordance with the authority invested in me by Motion 002 - 1(6) the Committee of the Whole will stay in session until it reports itself out with Mr. Irqittuq in the Chair.
Before we proceed to Committee of the Whole, I would ask you to join me for a short break in the lounge.
>>House recessed at 2.56 p.m. and resumed 3.24 p.m.
Chairperson (Mr. Irqittuq) (interpretation): Thank you for returning.
I would like to call the committee to order.
In Committee of the Whole we will have the following items to deal with; Bills 2, 3, 4, 5, 6, and 11 and Ministers’ Statement 020 - 1(6).
The committees wishes to deal with Bill 6, and the review of the Main Estimates, 2002/2003, continuing with Health and Social Services then Housing Corporation when we complete Health and Social Services.
Does the committee agree?
We’ll deal with the continuation of Health and Social Services and Mr. Picco, Minister of Health and Social Services, if you can, do you have your officials with you. Thank you. Sergeant-At-Arms, would you escort the witnesses.
Thank you for going up to the witness table.
Mr. Minister if you can introduce officials for the information of the committee.
Mr. Chairman, with me today is Deputy Minister of Health and Social Services, Mr. Andrew Johnson.
As well as the Director of Finance, Mr. Donald Maychruk and I would like to begin Mr. Chairman, by releasing information or giving information that was requested yesterday by the committee.
Yesterday we were on Health and Social Services. Branch Summary. Healthy children, families, and communities.
Page 10-8. Total operations and maintenance 31 million 382 thousand dollars. Any questions?
Hon. Ed Picco: Mr. Chairman, very quickly.
Yesterday I was asked by the member for the high arctic on the dental services the amounts in the budget and the breakdown of the same.
I’m prepared Mr. Chairman, with your wishes to give that information orally right now.
Mr. Chairman, under the NIHB Agreement which is the Non-Insured Health Benefits Agreement, we have 694 thousand 300 dollars for the following expenditures for dental treatment.
Those include the travel, the accommodations, the meals, freight costs for dentists, for buildings and a fee for service basis through the dental claims processing system.
The actual fees paid to the dentists are billed directly to Health Canada by the dentist and that’s through the NIHB, first Canadian Health costs.
These costs are not recorded on the financial records with the Government of Nunavut because they’re billed directly to NIHB.
The total cost of air transportation for eligible recipients of dental coverage is also covered under the NIHB Agreement.
In the Baffin Region, we have nine dental therapists at a cost of 796 thousand dollars; in the Kitikmeot Region, 432 thousand dollars, and in the Kivalliq Region, 688 thousand dollars for a total of 23 dental therapists.
Lastly Mr. Chairman, the total expenditure on dental services recorded through our budget process is 1 million 916 thousand dollars.
Chairperson (interpretation): Thank you, minister. Going back to page 10-8. Questions?
The question I had about 10-8 that I was going to ask the minister was already responded to.
Ms. Williams: The budget address referred to 1.7 million dollars in new monies for community wellness programs, 1 million dollars for community drug and alcohol counselling programs, 2.2 million dollars towards mental health addictions strategy.
My question to the minister is: approximately how much of the department’s overall budget will be dedicated to addressing the issue of substance abuse including programs relating to tobacco use, alcohol use and drug use?
My second question to that is how many staff positions are dedicated to addressing substance abuse including addictions, counselling and drug and alcohol workers?
Mr. Chairman, the health and wellness programming dollars as well as the mental health and additions workers, fall under two or three different areas in the budget.
So, I’ll need some time to be able to get those numbers together and give that information.
We’ll be able to do it before the end of the day; maybe while I’m answering other questions, we could find the actual numbers and so on if that would be okay.
Chairperson (interpretation): Anything else? I have no names.
Health and Social Services. Branch Summary. Healthy children, families and communities.
Total operations and maintenance 31 million 382 thousand dollars. Agreed?
Chairperson (interpretation): Carried. Turning to page 10-10, Health and Social Services.
Branch Summary. Health insurance programs. Total operations and maintenance 28 million 226 thousand dollars.
My question to the minister, these are all contract services and it says health insurance programs such as hospital services within Nunavut and other jurisdictions.
Does that include Ottawa, Montreal, Edmonton and Winnipeg?
Mr. Chairman, the member is correct, it does include those.
So, we’re spending roughly 28 million dollars for services, hospital services which is around 20 percent of the health budget.
Does this include the boarding home contracts or is that under a separate line item?
Mr. Chairman, yes that includes that amount.
Mr. Chairman, does the minister have the information on how much it costs us to run the boarding homes roughly, I don’t want to take it down to a dollar or a hundred dollars.
What’s it cost us to run these boarding homes for a year?
Mr. Chairman, the contracts that we have with the independent operators who run our boarding homes is an insured cost under Non-Insured Health Benefits.
We bill those costs back to the NIHB and we’re just getting that amount right now for the member.
While he’s getting that number, is there, and I’m sure there is, but how does the department evaluate how well run these boarding homes are in regards to, are we getting our dollars worth?
Is there a monitoring, I know that there is an RFP goes out and they say that they want all these specific things done in order for them to award the contract to the best individual that answers the RFP, that they are fulfilling their obligation to run these boarding homes.
Is there somebody in the department specifically that does an evaluation on them on a six month basis or a yearly basis?
What I am getting to here is any other contract in the government whether it is building a house or supplying a certain computer, that the people involved look at making sure that the government is protected and getting value for their money.
Is that the issue with health that they are monitored and evaluated on a six month or a yearly basis?
Mr. Chairman, first of all on the first question that Mr. McLean asked.
The total value of the boarding of our hospital patients, and that includes North and South Mr. Chairman, just for the record that is the boarding home in Iqaluit, the boarding home in Yellowknife, the boarding home in Edmonton, the boarding home in Winnipeg, the boarding home in Churchill, and the boarding home in Ottawa.
Mr. Chairman, the total amount is 8 million 897 thousand 973 dollars for the boarding of our hospital patients.
That is the value of the contracts that are in place to date.
Mr. Chairman, on the secondary question by Mr. McLean, concerning the boarding home policies and procedures, at the moment Mr. Chairman, we are actually doing a review of all the procedures and policies at the boarding homes.
The member is correct; on the new RFP’s that have come forward there are stringent policies and procedures as well as guidelines for the operation of our boarding homes that the contractor has to follow up.
On a regional basis from the regional offices, there is a follow up and contact as well as review on those policies, procedures and guidelines on a regular basis.
One of the things that we are in the middle of doing right now as I said earlier again, to ensure that we review all the policies and procedures at those boarding homes.
An example would be the issue of gambling that has been raised in this House that was not covered in the policies and procedures of the boarding homes but it will be part of the review that we are commencing in the next couple of weeks.
As we evolve and we know that the population in Nunavut, fifty percent of them are under the age of twenty-one, there is going to be more movement, there is going to be tremendously more movement of patients to the South.
Nine million dollars in boarding home costs out of twenty-eight million which is around twenty-five percent of the costs so we are actually paying about twenty million to the hospitals in the south for the care, I don’t question the care we are getting in the hospitals in the south.
I think that it is probably the best in Canada.
Going back to the boarding homes, I went through this a few times myself last year that I know that patients go down for the medical.
And the reason I was asking on the evaluation is, I think it is 150 dollars a day that we are paying these boarding home operators for patients, which is hotel rates.
The point I am getting at here, okay patient “A” goes to Winnipeg and they are down there for three weeks, and they are in the hospital for fourteen or seven days.
They left their suitcase in the boarding home.
Like I said I have experienced this myself last year with a few individuals.
Do we pay the full cost of that boarding home when the patients are in the hospital?
Or does the boarding home give the government a credit back?
Or is the boarding home charging the 150 dollars a day while the patient is in the hospital?
Mr. Chairman, just for some clarification, Mr. Chairman the rate of 150 dollars in incorrect.
There is no boarding home operated by the Government of Nunavut where we pay 150 dollars a day to a contractor.
The maximum that we pay right now is 144 dollars and it is as low as 102 dollars for a specific boarding home.
Mr. Chairman, those are the rates that are in place as of today.
Again, a secondary question from the member, all costs for hospital stays, whether it be an overnight stay or at the boarding home those costs are covered and those costs are billed out depending on what the facility costs are.
For example, a hospital stay in Winnipeg may be more expensive than a hospital stay in Edmonton or an Edmonton stay may be cheaper than a Yellowknife stay.
So it depends on the location for the costs.
I stand corrected; thank you for correcting me on what it costs to stay in a boarding home per day.
I’m sure the minister, when he has time we’ll make it available to the members, the different rates the boarding homes are charging down south.
The Winnipeg Boarding Home, the Edmonton Boarding Home, and I think the Ottawa Boarding Home, just for my piece of mind so I know that the rates are competitive and fair.
But getting back to the second part of the question I asked.
If somebody goes down there for two weeks and they spend a week in the hospital, does the boarding home get the two weeks, do they bill the government for two weeks or do they bill the government for a week and give you a break on the week.
What I’m getting to here the actual client is the contractor charging the full rate when the client isn’t there, when the client is in the hospital.
I think I made it very clear there.
Mr. Chairman, my understanding is that when a patient is at a hospital, overnight in a hospital, then there’s no charge to the boarding home.
The boarding home cannot double bill.
They cannot bill us as a government for time when the patient is at the hospital.
So, they’ll only charge or the only billing, the only accounts receivable that is due to the boarding home is when in actuality the patient is physically staying at the boarding home.
The reason I brought up the 150 dollars price is there was a contractor running a boarding home was telling one of my constituents that they get 150 dollars day when the place is full and when they have to send them to hotels and I really, it’s not a question of 150 dollars at all because a good hotel in Winnipeg is 160 dollars or 175 dollars.
So, if we’re getting rates of 102 dollars a day for 3 meals, taxi services, and a good bed, I think the government’s getting good value on that and I certainly wouldn’t question.
But can you confirm to me again we’re not getting double billed on these empty beds when clients and how do you check this.
Is this contractor left to his own devices as to say this isn’t happening or is there some way of monitoring it?
Mr. Chairman, in Rankin Inlet we have a control office under the Non-Insured Health Benefits.
That office there reports, receives reports which are cross-referenced and cross-checked with our patients itineraries and so on for the boarding homes.
So, that’s how we cross-check and cross-reference.
There are no double billings in those cases.
In that case, if there was, that would be fraud, this is a Non-Insured Health Benefit which we charge back to the federal government, and of course the federal government has an opportunity to audit any expenditure that they also do.
So, there are several mechanisms in place to check that.
On the rates themselves, I can provide the rates to the members if that was requested in committee or out of the committee.
As far as I’m concerned he can provide it outside the committee in a written format.
I’d just like to see it for my own beliefs.
I’m getting off topic here, but it’s regarding boarding homes and it is here. Now when we dissolved the three, or when you guys, the government dissolved the three regional health boards, and we all agreed to it, we set up, or you set up, or the government set up these health committees and I’ve got one in my community now that’s very active.
I get a couple of phone calls a week in regards to what’s happening with health.
This group is very active and I’m sure the other communities probably have these health committee groups, as committees of council.
The thing is here, I don’t like to burden you because I know you’re a very busy man with every little incident of being out of Tylenol and things like that.
Because I don’t think I should be bringing that up in the House.
Are there people identified in each region that the health committee can talk to in regards to their concerns and questions?
I’ve got ten pages of health committee meeting issues here that I was going to table tomorrow for you and ask questions about it next week.
You know, rather than backlog you with every little concern in my community, can you identify somebody in my region, that can deal with these issues and if we have somebody identified, could you let me know.
Mr. Chairman, that’s a good question.
We have in the three regional offices, in the Keewatin, the Kitikmeot as well as here in the Baffin, based on the same regional offices that work with our local health committees, and any concerns that are raised from the health committees can be facilitated in numerous ways.
They can for example, bring their concerns to the MLA who then directly brings it to us in letter form and that has happened on numerous occasions by several of the MLAs.
There’s also the opportunity to bring it forward in your region, we actually have a community development officer that is in place that can be brought forward to him, that’s John Puckard, who is based in Rankin Inlet.
Again, you can bring it forward to the regional director for health in each region.
In the Baffin region for example, we actually have two, one for North Baffin and one for South Baffin, both based in Pang.
So there are several different ways to bring forward those concerns to the minister and to the minister’s office.
Chairperson (interpretation): That’s it?
I have a number of questions in regards to the contract services.
I believe that for all the communities in Nunavut the contract services in the south are 28 million 226 thousand dollars.
My question is in regards to, especially here in Iqaluit, it’s in regards to the medical boarding home that is utilized by the patients.
The patients usually go to the boarding home here.
There are the pregnant women; the people here go to see a doctor or to see the specialists and mental health patients.
How do you deal with the patients when they’re here in the boarding home?
Mr. Chairman, if I understand the member’s question correctly, when patients are referred to Iqaluit there are three opportunities first of all for boarding patients.
One of them is the Tammaatarvik, two is private homes and three is through the commercial accommodations at the hotels if they’re government employees, they have that option.
If a patient is staying at the Tammaatarvik boarding home, we endeavour to have them picked up at the airport.
They are arranged to stay at the boarding home and then they are also, a van is provided to take them back and forth to their appointments.
If they are staying in private accommodations for example, Mr. Chairman, if they’re staying at my house, the van will come and pick them up if they phone Tammaativvik and say that they need a ride to the airport for example or if they a ride to the hospital for appointments.
So, I think patients are taken care of quite well when they come to Iqaluit and the elder’s society group in Iqaluit here runs the Tammaativvik and I believe they’ve done an excellent job in providing a good service for us over the last few years with that contract at Tammaativvik.
My next question: before I get into the Main Estimates, and while we’re under health insurance programs: you stated that they have three options when they come to Iqaluit.
If they were down here for mental services usually they tend to be on the high scale when the moon is full.
How do you take care of the mental health patients or patients who are down here to see a psychiatrist so that they don’t disturb the other patients that are staying at the boarding home?
Mr. Chairman, it’s an interesting question.
Mr. Chairman, with psychiatric patients, depending on the psychosis or the severity of the illness, we have in place, for example security at the hospital, as well as an inpatient room for psychiatric patients if they need that.
If they’re going to be, maybe if they were a danger to themselves or to others, that’s one of the protocols that is in place.
If the person’s coming down for example, for a psychiatric review or other appointments for mental health then the conditions allow and again because of the confidential nature of health concerns and so on, we have to be very careful what information is left not only to the Tammaativvik staff but to other staff.
So, there are policies and procedures in place in regards to psychiatric patients that need counselling services as well as appointments to regularly scheduled doctors in Iqaluit, either at the hospital or indeed to some of the private doctors if that was what was being requested.
My next question: you stated that there were three options for the patients.
They have the option of staying at the boarding home or in a private billet, or in a commercial hotel and following up with the Mr. McLean’s question, we pay approximately 150 dollars per day, per patient, and if there’s an overflow at the boarding home, they are billeted out to the local residents and I believe, that they get paid very little, much less than 150 dollars.
If it’s a large family they have people to feed and so on.
What is the scale or how much is the paid to the billets because I don’t believe it’s 150 dollars per day.
If the minister could clarify that point, I would appreciate it.
The amount for private billing is approximately 50 dollars a day.
How much for commercial hotels?
Mr. Chairman, the commercial rate is available to all government employees, so in the case of, if the hospital patient was a government employee, they’re allowed up to the maximum amount available for commercial travel as a government employee.
In the case of a private stay, the amount is approximately 50 dollars.
At the same time, when you’re staying in a private residence some of the other services that are provided at the boarding home are not provided for example, transportation and so on.
We pay the same amount for private stay and again, as is allowed under the agreements that are in place for accommodations.
What about the people that are staying in hotels.
How much per day is paid for those?
Mr. Chairman, it’s similar to the duty travel rate.
For members for example of this Assembly who are here, they are allowed x number of dollars based on the duty travel rate to stay in commercial accommodations.
If a member stays in private accommodations, you’re allowed up to a maximum of x number of dollars.
It’s the same thing with the hospital patients.
If you’re a government employee, you’re allowed up to the maximum that’s allowed for duty travel to stay in one of the commercial accommodations at the Frobisher Inn or the Navigator, one of the hotels and so on.
If you are staying with a private family, then you are allowed up to a maximum of 50 dollars, the same as members or any of the other government employees who would be travelling on duty travel.
That is my understanding on the policy that is in place.
I’m talking about the patients who are not government employees.
Government employees, if they’re on duty travel and come down here, I’m sure that they have their reservations and their maximum and so on.
You stated that the government employees, who go down here for medical purposes, have the option of staying in a hotel and we pay a lot more expenses for that person if he’s not billeted.
There has to be something more uniform in the rates that are paid out for patients.
If you could explain that further.
Mr. Chairman, well first of all, there are different options available.
For example, Mr. Chairman, under the Green Shield program that is in place for government employees, they have health care that is above and beyond what’s available to Nunavut residents with their Nunavut health card.
So if a Nunavut resident, who is a government employee, is travelling, they have the option of staying in commercial accommodations and those costs would be covered for them.
If a person is travelling and has no health care, through the government for example because they’re not a government employee, they are able to stay at the boarding home whether it be here in Iqaluit or in Ottawa or Edmonton or Winnipeg.
Those costs are completely covered by the NIHB, the Non-Insured Health Benefits.
That mean people who don’t have health benefits, they are non-insured, they don’t have insurance.