EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
Mr. Barnabas (interpretation): The money that is in place for the community health representatives, have you looked at the kinds of funding for them and what kinds of other programs will you be initiating for them?
The current funding for health committees will remain the same in this fiscal year.
Once we go forward with the review of the Health Integration Report, which put very specific recommendations on some committees, then that will be part of that review process. But for this fiscal year, we’re looking at maintaining the budget as presented.
Chairman: Questions on Directorate.
Under the Directorate there is a policy in place where today I directed questions to the Minister of Finance.
In the last question, the Premier stated that if they can get the assistance of the federal government, and when they know they will be receiving assistance from the federal government for auditors training, and if they can also get assistance from the federal government with regards to nursing courses, that they would be able to provide that, just like the Akitsiraq Law School.
I would like to ask the minister: have you asked for support from the federal government, and if so, have you had any success in the federal government wanting to assist you in the training of nurses in Nunavut?
The way I understand how the law program was delivered and developed in Nunavut is that each individual participant in that program was sponsored by an employer, whether it be the RCMP, the federal government, Nunavut Tunngavik Incorporated or Inuit organizations, or the Government of Nunavut.
They were sponsored by those organizations and paid by those organizations, and I think that is what the Premier meant in terms of partnership in sponsoring students, as a follow up to the Minister of Finance’s comments.
Similar to that in the delivery of financial training, I believe what the minister had said was looking at partnerships similar to the sponsorship identified through the law program. In health, we are the employer and we are the only employer that provides services and/or employs nurses.
So, in Nunavut, if we’re looking at sponsorships for nurses, it’s a bit more of a challenge because we are the sole service provider in that sector.
So that is where the difference in those two programs lies around sponsorship issues. I hope that clarifies that.
Mr. Arvaluk (interpretation): Thank you, Mr. Chairman. Yes, I understand how Akitsiraq Law School and the professional accounting course would be run and who would be sponsors, but I just wanted to find out if you have requested funding from the federal government.
NTI has to look after the Inuit of Nunavut, the beneficiaries.
Because there is funding available from NTI for harvesters assistance under the Harvest Program, why can’t the department of Health try to be the lead department to talk with NTI, saying that Inuit of Nunavut have to have hospitals and can’t you talk to Indian Affairs.
Under the Nunavut Act, it is your responsibility that we have shortage of nurses, can you provide some money in order for us to train them.
Have you held any discussions like that as a Health Department?
I believe I have provided some of the answers to that through question period. I am working with the Minister of Education, who currently delivers the nursing program in the north through the Department of Education.
I had committed yesterday, to providing further information as to what kind of financial support we provide the nursing students when they are in the program, during summer break, and the support that we are looking at in terms of hiring, orienting or mentorship when they graduate.
We also provide $326,000 in scholarships for the nursing program, so I committed to providing that information to the member.
Currently, the program, the nursing program in Nunavut is GN sponsored, solely by the GN. We’ve had some discussions with the federal government on other training initiatives, such as mental health training, that was sponsored by the federal government funding we received, as an example.
But I had committed to the member to reviewing the matter with the minister of Education who delivers the nursing program in Nunavut.
I guess that the short answer is no. I have not spoken to the federal government or NTI to seek partnership to help better finance the nursing program?
If that is the answer, can she then take the leadership role and start talking to other potential partners, to improve the nurses’ training program so that the success of the nurses’ program can be improved, with less dropouts by having better living conditions for nursing trainees.
Hon. Leona Aglukkaq: Thank you, Mr. Chairman. I committed to providing that information to the member, once we have done the review, I will report to the member on that.
Again, I have to work with the minister of Education responsible for delivery of the nursing program.
I think that we have done a lot of improvements internally, as the main employer in the field for nurses in Nunavut. We made the commitment to hire the nurses upon graduation, we have developed the mentorship program; we have the scholarship program in place at the GN. Yes, if we can get more assistance from NTI or the federal government, it would be of great assistance to us.
But I have to work with the minister of Education in that review, so I will commit to providing that information to the member.
My last question is will all these commitments be done before the next school year. For example, by fall, can she report to us by the spring session?
I will try and have that information to the member by the spring session.
Chairman: Mr. Tootoo, I will allow you one ten-minute question.
Mr. Tootoo: Thank you, Mr. Chairman. Does that mean if I only have one question I can take ten minutes to ask?
A few questions, Mr. Chairman. One of the things that I have here is in this Directorate deals with health insurance programs.
I am just wondering if the minister could inform us as to what the current status of negotiations with Non-Insured Health Benefits, especially in the areas of transportation and accommodation for medical clients.
Mr. Richardson: Thank you.
We are preparing for negotiations with the federal government on these topics.
We have regular management meetings to initiate it and so we are the midst of preparing for that set of negotiations.
I know over a period of time now one of the things that have been discussed is when we’re looking at boarding homes, and the expansion and requirement for expansion of boarding homes, that was all in negotiations that were ongoing with the federal government because they’re the ones that pay for it, and now I hear that they haven’t even started the negotiations yet.
I am just wondering if I can get a clarification on that.
I believe that we’re in the Directorate and now we’re getting into the Health Insurance Program, which is under H-11, so could we deal with it on H-11. I think we’re trying to cover everything and it’s holding up a lot of other topics that could be discussed when we get to them, so that is my Point of Order.
I don’t know where my good friend from Iqaluit West is coming from on that but under the Directorate and business plan for the Department of Health and Social Services, there is a section there for Health Insurance Programs and Vital Statistics, so that’s why I am asking that question there.
Chairman: Mr. Tootoo, your question is on page 11 and I would ask you to ask that question when we get to page 11.
Any further questions to Directorate on page H-5?
I would like to ask for further clarification on that.
There is Health Insurance Programs under Directorate and that’s why I am asking that question there. If you look at H-12 of their business plan it falls under Directorate, there is $1.2 million there for health insurance programs and it talks about the fact that the management of the administration of the Nunavut Health Insurance Program, Non-Insured Health Benefits, and Extended Health Benefits. It’s under Directorate.
Chairman: Committee, please check out the Business Plan on page H-12.
Health Insurance Program.
Vital Statistics.
Rather than just going back and forth debating that, I would prefer if we would deal with the main estimates, otherwise if we’re not going to be approving main estimates on the page-by-page and now we’re going to do the same for the business plan, I think that’s a bit confusing.
The area related to health insurance, as indicated by the Premier, relates directly to the medical travel, the Non-Insured Health Benefits funding we receive from the federal government; it’s right in that category.
So if the member is willing just to hold off on that question until we get there that would be more useful.
The information under the business plan relates to the Vital Statistics Office as well, which is the issuance of birth certificates and so on, which is beyond the member’s question.
Chairman: We will take a five-minute break.
>>Committee recessed at 16:08 and resumed at 16:20
Chairman: Let’s get back to this committee meeting.
Mr. Tootoo I would like to ask you a question; is your question on administration to the program, or Health Insurance Program?
I thought I made it very clear that under Directorate, the Health Insurance Program/Vital Statistics is responsible for the management and administration of the Nunavut Health Insurance Program, non-insured health benefits and extended health benefits.
I would assume if they’re responsible for the administration and management of those programs it’s through that area that they’re doing the negotiations on those programs itself, not the actual program delivery.
Chairman: Mr. Premier, you have no point of order to the administration.
Mr. Tootoo’s question is on administration.
The business plan supports the main estimates. The Minister of Finance’s tabled both at the first reading of Bill 1.
My question was; the minister’s officials said they are preparing for negotiations on that and it was my understanding that we’ve been told for at least two or three years now that these negotiations are under way.
So I was just asking for clarification on what is it?
Have we been negotiating for the last couple of years or are we just getting ready to negotiate as he had indicated?
The areas where we have been negotiating related to boarding homes was with the situation in the Ottawa boarding home that was in negotiations with Health Canada in trying to move forward in addressing the boarding home situation in Ottawa.
Overall, the department has been preparing to deal with Health Canada on a number of things covered under health insurance related to the boarding homes, the Dental Programs, the Vision Program, the Medical Travel Program; that budget is identified under health insurance, and the department has been preparing to deal with that piece separately from the situation with the Ottawa boarding home discussions that have had in the past.
If memory serves me correctly, and I stand to be corrected, I know that argument of we’re in negotiations right now has come into play with questions in regard to the Lena Pederson Boarding Home in Yellowknife, and also with the boarding home here in Iqaluit, they’re looking at expansions and that.
So, I’m just wondering if those negotiations have been under way, where are they at?
When can we expect some results to that?
We have had no negotiations with the Yellowknife boarding home, and Iqaluit boarding home.
Maybe I need to clarify it a little clearer.
I said the argument when questions were asked in regard to expanding the boarding home here and dealing with problems and concerns raised about the Lena Pederson Boarding Home in Yellowknife, the argument that the government gave us is because those fees are paid by non-insured health benefits, they have been in negotiation with the federal government on those fees.
That’s what I’m trying to find out, where things are at, and when can we expect some results on that. I never said anything about negotiating with those two bodies, those two boarding homes separately.
Thank you, Mr. Chairman, I hope that clarifies it.
The negotiations that we have had with Health Canada was around the Ottawa boarding home, in terms of agreeing to a rate to deal with the challenges that we are addressing in Ottawa to move forward in expanding the services.
It has nothing to do with Yellowknife and/or here.
The minister, I’m sure will correct me if I’m wrong but I seem to recall, I don’t know if it was this minister or the previous minister saying they were trying, they can’t deal with that separately, they were trying to come up with a comprehensive plan dealing with all of those places, it would affect all of those places before coming up with something.
So, again, I’m a little confused.
Now we are hearing it is just specifically to that one when we’ve been told in the past that it’s all interlinked and they were trying to broaden it to make it all encompassing in the past. Maybe I can get some clarification on that.
To clarify, two things are happening.
The negotiations that we did have related to Ottawa boarding home, the other piece that we are dealing with, in order to move forward on the boarding homes for expansions or whatnot, Health Canada has asked us to put a package together for all the current facilities that we have operating and to deal with the issue of boarding homes and rates collectively.
Health Canada is aware that we will need additional boarding homes in Rankin Inlet and Cambridge Bay and have asked us to put forward the situations or needs of each facility that we currently operate and that was aside from what we were dealing with in Ottawa, just because of the urgency of that situation.
Then if it is a totally separate thing, then the minister should be able to give us an idea how those negotiations went with Ottawa in relation specifically to the boarding home in Ottawa that a lot of people have raised and members have raised concerns about in fact.
We are working very closely with Nunasi on that situation and there is progress in moving forward with dealing with the Ottawa situation.
Can we get some little bit more detailed than that?
We are working with Nunasi again and we are moving forward in constructing a new facility in Ottawa.
When does the minister plan on doing an announcement on that and when does the facility plan on being opened. So I guess as far as the status of those negotiations, they were completed and they were successful because we are getting a new boarding home, is that correct?
The situation in terms of timeline, I would have to get that information from the service provider which is Nunasi Corporation in terms of timeline, construction, and so on.
I can get that information to the member. In terms of moving forward and being successful, yes.
It’s nice to hear that. I’m sure a lot of people that are going to be travelling down for medical to Ottawa will be looking forward to staying.
So maybe I can just ask the minister when that decision was made.
Hon. Leona Aglukkaq: The issue around agreeing to a rate was some time in December.
I guess that was the closing of the negotiations if there was an agreement on a rate.
Can the minister indicate when the decision was made to let the service provider know that they can go ahead and build a new facility?
Hon. Leona Aglukkaq: Thank you, Mr. Chairman. That was the response; in December.
When was the minister planning on informing everyone else about that?
We were still dealing with the situation of acquiring the land with Nunasi. Nunasi is working very hard to try and get the land.
So, once that was settled, we wanted to go do that announcement. They are still working to try and find suitable property in Ottawa and once we know that, we were looking at doing the announcement.
But, right now we do not have the land acquired in Ottawa to start, as far as I know.
I look forward, and I’m sure all patients look forward to them getting the land and having a new facility that is more suitable for them to be in.
My next question deals with something that the department’s previous business plan had put a considerable amount of emphasis on, and that is the Care Closer to Home Strategy. However, this year’s business plan makes hardly any reference to that at all.
So I would just like to ask the minister what happened to the Care Closer to Home Strategy.
In terms of Care Closer to Home, there are some initiatives that we have moved forward on from the Care Closer to Home such as the Continuing Care Facility, and so on.
In terms of moving forward on all the recommendations in the Care Closer to Home, I think members know in this House that the budget before us is status quo.
We cannot afford to provide every service in the north as outlined in the Care Closer to Home.
In areas where we can, we have moved forward in some of those, such as the Continuing Care, training of our staff, or potential staff through the college programs and so on. So, that plan is still there, it’s just that we cannot move forward on all the recommendations.
The other piece I mentioned, discussed yesterday was around the opening of the hospitals and the issues around the challenges of getting the houses to open those facilities and the boarding home situation.
Again, those are all of the pieces around the whole concept of Care Closer to Home that we have been trying to move forward on.
I have a question on dealing with something that came up at the regional hospital here in the past and it’s something that we still face and I believe that this is the area to establish and maintain professional standards. My question is dealing with the accreditation at the Baffin Regional Hospital. I know you asked for in January and we provided an extra $2.3 million to address some of the problems with the accreditation of the hospital there.
I’m just wondering if the minister could give us the status as to where things are at with that when you said at the time it was going to be 18 months before we get accreditation back. It has been just about 18 months now, so I’m just wondering if I could get a status report on that.
To update to the members around the accreditation, we had set a timeline to try and address the recommendations outlined in the Accreditation Report. When the report was released, we responded by also allocating additional incremental funding to enhance the gaps in the positions and services that were required. Of the 26 positions that were created as part of the overall accreditation recommendations, more than half of those positions have been filled in the hospital.
Since that time, the Canadian Accreditation Organization changed those standards. They came up with a different set of standards throughout Canada around hospitals and so on and asked us, because we were right in the middle of trying to address their first recommendations, but while we were in the middle of addressing those recommendations, the accreditation company changed their standards, which meant that we had to go back and say, ‘What changes did you apply?’ and address those changes.
So in light of that change from the accreditation company, they asked us if we would be willing participants to be a pilot in implementing those new standards that they created. So we agreed to that, and at the same time we agreed to broaden the standards, not just with the facility here but to expand those standards to the upcoming two new facilities and for Nunavut. So that is where we are at and we continue to work with the accreditation organization on those recommendations.
The other piece that we’re dealing with in dealing with just the hospital here is that we don’t have enough space for all those positions, so we are trying to enhance the capacity, or the recommendations outlined in the report but we need the space to put those individuals in the hospital.
So part of addressing those other, less than half there, new positions will be phased into the opening of the new hospital where we have the space to place the new employees that are to address the issues outlined in the Accreditation Report in the hospital.
I guess my next question is: when can we expect to have our accreditation? We were told last January that we would have it in 18 months. 18 months is just about gone, so I would like to just ask the minister when we can expect to have the hospital accredited again.
The 18 months was identified as a target we would work towards when the Accreditation Report was released. Since that time, the accreditation organization changed their standards.
So we have to go back and evaluate their original recommendations and what they changed since then.
So it will be more than 18 months and we are working with the accreditation organization to address those.
Again, the original target was based on the original report, and because they have changed those standards, we’ve had to go back and say, ‘Where did you change your standards’ and what do we need to change in our plan and so on, and what impact do those standards have on your original recommendations.
So that’s the challenge we are tasked with, plus we are expanding developing standards, not just for the hospital but throughout the territory and our facilities. So that’s where we’re at.
Mr. Tootoo. Question on Directorate. Go ahead.
Again, I know that’s where you are at, you said it a few times, but I missed the bottom line. When? Is it another 18 months; is it another five years; is it another six months?
When can we expect to have that nice sign swearing that the hospital is accredited back up at the hospital?
Hon. Leona Aglukkaq: Thank you, Mr. Chairman. 18 months was the target that we set ourselves to try and address that. The Accreditation Organization has asked us to pilot with them for a year.
So I guess it is a year from now that we are going to be looking at bringing him back in for a resurvey to see if we meet accreditation standards?
That would be the plan, we have to work with Accreditation Organization that introduced new standards and work with them, so we are hoping, they had said one year, so we are working with them for that target.
I know there was a, at the time there was a big emergency and a rush to, I believe there was a supplementary appropriation brought forward for that $2 million plus $300,000 of funding to find within.
Given that the minister indicated they have only hired half of the people necessary to what they had outlined there, I was just wondering when they plan on having the rest of that covered off and what have they done with that money in the meantime.
More than half of those positions have been filled through direct appointments, indeterminate, or casually.
We are trying to recruit for the rest of the positions for the hospital, the challenge we have is we have no space to put them in the hospital, so in order to move forward and expanding the hospital we hope to place those positions as we move towards the hospital.
Right now the challenge is: where do we put them in the hospital to address the accreditations recommendations for the hospital.
I am just wondering then why the department and the minister felt it necessary to ask for the full $2.3 million at the time to cover the costs of filling those 26 positions. Did they not know at the time that they didn’t have the space to put all those positions?
The plan was to try and address all the positions we needed for the hospital, and we put the request forward at that time to address the recommendations in the accreditation report.
The challenge arrived when we discovered that there was not enough space in the hospital to provide all the services which were identified in that report and that’s the way we are right now and based on the information we received at that time that was what we had gone forward with to address the report’s recommendations.
I just want to confirm that the minister indicated that they didn’t realize at the time they asked for all that money that they didn’t have a place to put those people; that they never found that out until after. Is that correct?
To some extent that would be correct.