EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
Mr. Speaker, it states that the Department of Family Services, working with NTI and other partners, is developing community initiatives and building social networks.  Mr. Speaker, can the minister educate me on what role Family Services is playing within that group of stakeholders, and what type of initiatives and networks are they looking at implementing?
I thank the Member for Iqaluit-Tasiluk for the question regarding social supports.
We follow these things according to guidelines because there are many people in the communities that go through difficult times. We are trying to come up a policy and framework that we could base our participation.
We have continuing meetings with NTI.
That is the way that I could provide the answer to that question.
Also in the Budget Address, it mentions that it is bringing people together with a dedicated Poverty Reduction Fund. The anticipated allotment of money from that fund, what is the Department of Family Services role in that, and are there other stakeholders actually putting funds into this Poverty Reduction Fund?
I thank the Member for Iqaluit-Tasiluk for the question.
In terms of how we would utilize the financial resources, as stated by the Minister of Finance, we meet with the communities and we are beginning to understand how we can frame the regulation in terms of creating a better quality of life.
We also work with the Department of Education in terms of ensuring that the children are raised properly and grow into responsible and respectable adults.
We will be able to have discussions with them in terms of how to reduce poverty.
We also work with the local housing authorities and with the Nunavut Roundtable for Poverty Reduction. I can say that they have been providing assistance to us in this area.
I think the minister may have misunderstood my question in some part.
The Poverty Reduction Fund, what I’m looking for is: who is going to be contributing dollars to that fund and what is the anticipated budget of it?
Hon. Jeannie Ugyuk (interpretation): Thank you, Mr. Speaker. I thank the Hon. Member for Iqaluit-Tasiluk for that question about specific financial resources. That is the way I understand him.
The financial resources could be provided, I think. I will provide an answer when I know the proper information in terms of the amount of dollars because I do not have those numbers at my fingertips at the moment.
Ms. Angnakak (interpretation): Thank you, Mr. Speaker. (interpretation ends) I would just like to ask if we can go back to Item 5 on the agenda, please.
All those in favour of going back to Item 5. raise your hand.
Ms. Angnakak: I recognized Gwen Healey earlier, but she was not here. Now that she is here, I would like to take this time to welcome her to the Legislative Assembly and just to tell you that, once again, Gwen is a brilliant mind.
She is working on her PhD, she has lived in Iqaluit all her life, and she graduated from Inuksuk High School.
This is a really successful story that we can tell about Gwen, who has gone through the high school system here in Nunavut and is about to get her PhD. Welcome.
Thank you. (interpretation ends) Item 7.
Tabled Document 014 – 4(2): Public Service Annual Report 2012-2013 (Peterson)
I am pleased to table the Public Service Annual Report for the period 2012-13.
Bills 2 and 3 with Mr. Enook in the Chair.
In accordance with the authority provided to me by Motion 3 – 4(2)… . Before we proceed to the Committee of the Whole, we will take a 20-minute break.
I skipped a sentence. (interpretation ends) In accordance with the authority provided to me by Motion 3 – 4(2), the committee will stay in session it reports itself out.
>>House recessed at 15:04 and Committee resumed at 15:28
Good afternoon to the people of Nunavut who are listening and watching the proceedings. Welcome to the Legislative Assembly of Nunavut proceedings.
In Committee of the Whole, we have the following items to deal with: Bill 2 and Bill 3.
We wish to continue with the review of the main estimates for the Department of Health, followed by the Department of Community and Government Services and, if time permits, the Department of Education.
Chairman (interpretation): Do you agree that Minister Ell and the witnesses can go to the witness table?
Sergeant-at-Arms, if you can escort the witnesses in, please.
Welcome, Hon. Minister. For the record, could you introduce your officials at the witness table, please.
To my right is Interim Deputy Minister Rosemary Keenainak and to my left is our Interim Finance Controller, Johan Glaudemans.
Welcome officials to the witness table.
We can now proceed to the review.
Before we proceed, I would like to remind members of the following: according to Rule 77(1), subject to the discretion of the Chair, a member may speak more than once to a matter under discussion but not until every member wishing to speak has spoken.
We will move on. Are there any questions to this page?
Any further questions to page H-5?
Branch Summary. Health.
Turn to page H-6.
I’m sorry. I did not understand the Inuktitut version.
I will read it in English. (interpretation ends) Health Care Service Delivery.
My question is home care and community care will continue to be a vital service when it comes to the elderly. Helping them stay at home and independent should be a priority of this government.
Has your department reviewed this area of service to determine if the demand of this type of service is growing or not?
Before the minister responds, I would like to remind the regular members that if you have a question on page H-6, please raise your hand ahead of time so that we can put your name on the list.
Moving on, (interpretation ends) hon. minister.
The Home and Community Care Program is part of an assessment that is currently taking place.
Ms. Angnakak: One of the department priorities states to enhance long-term care services.
Can you describe what types of enhancements are being considered?
Part of the plan moving forward is identifying the strength of the current health care program, including the delivery of services in a culturally sensitive manner and lowering costs for out-of-community travel for health purposes, but identified limited training opportunities as a concern.
Also, part of the process is that down the road, what we’re also looking at is when we’re creating health centres the plan is to identify, perhaps two to however-many beds in the community can be set aside for either respite care and other programs for elders.
Can you list-off some of the enhancements that are talked about in this program?
Through you I’d like to have my deputy respond to that.
Chairman: Qujannamiik. Ms. Keenainak, please.
Some of the things that have been enhanced have been increase the frequency of home and community care certificate courses that are provided, such things as personal care skills and other opportunities. As an example during 2013-14. Through Nunavut Arctic College Healthy Living courses offered approaches to respectful caring, the professional role of a home care worker.
For this particular fiscal year we’re looking at the following courses on human growth and development, recognition and referral of mental health and first aid.
Those are the kinds of things we’re doing to provide additional training particular to home care workers. We’re continuing to evaluate the needs at the community level to try and make sure that we have staff at the community level that are able to provide some of those services.
Chairman: Thank you, Deputy Minister Keenainak.
Elder care is becoming a much needed service and is one area that I feel is growing in demand. I’ve brought this up before in the past.
What is the status of the Comprehensive Elder Care Strategy now?
Chairman: Thank you, Ms. Angnakak. Minister Ell.
We are just in the process of starting that.
Ms. Angnakak: Thank you, Mr. Chairman. Thank you for that answer.
Going on then; how is the Department of Health addressing the growing demand and need of providing mental health services at the community level?
We are currently working on enhancing the mental health ability in the communities. Moving forward, we’d like to see more community psychiatric nurses and mental health workers, as an example.
Ms. Angnakak: Thank you minister for that answer.
I’d like to go on in that area and ask how many mental health workers do we have in Nunavut?
Can you hold on a few minutes I saw it over here and I’ll give it to you?
The mental health workers in the communities in the Qikiqtaaluk and Kivalliq region, and in other areas, the total of psychiatric nurses is 23.
Ms. Angnakak: Are the numbers adequate to address the growing numbers of mental health issues that we have in Nunavut, including addictions and suicide?
What strategy do you have in place to increase the number of mental health workers to address the need?
There is a lot of work that has to be done in regard to mental health, but we are in the planning stages. We already answered the question.
(interpretation ends) The mental health and addictions framework for action is a plan to expand mental health and addictions services capacity with a long-term objective of moving from reliance on acute services to utilizing community-based support, prevention, and early intervention services.
The plan focuses on four key areas: quality programming, human resource capacity development, community capacity building, and resource leveraging.
Thank you for that answer. It seems to me that one of the problems is that we do not have enough support in the communities. How are you going to build the support that can address your action plan?
The mental health and addictions framework for action provides a blue print for developing a service continuum within the territory with emphasis on working with communities to enhance community-based support, prevention, and early intervention services.
The Department of Health is revising a business case aimed at achieving the following objectives: creating new and permanent mental health staffing positions in communities, moving forward the objective of having a psychiatric nurse working in all communities, filling the vacant skilled local workers position aimed at local workers without a formal education, and increasing the professional developments of work provided to frontline staff.
Chairman (interpretation): Thank you, (interpretation ends) Madam Minister.
When do you hope to have all of that implemented?
Chairman (interpretation): Thank you, (interpretation ends) Ms. Angnakak.
Subject to adequate funding being invested, it is an objective of the mental health and addictions framework for action that, by April 2018, beneficiaries will fill at least 40 per cent of the frontline service provider positions within the mental health and addictions services system in Nunavut.
Chairman (interpretation): Thank you, (interpretation ends) Minister Ell.
When you talk about psychiatric nurses, are you targeting that with Arctic College for the nursing program? Do you want to have 40 per cent beneficiaries in the list of personnel that you said that you would be setting at the community with?
Does that include working with Arctic College’s nursing program?
Chairman (interpretation): Thank you as well.
Are the mental health workers that you have now supporters and trained well enough to deal with family and community trauma, especially surrounding the issue of suicides?
The psychiatric nurses are qualified with proper backgrounds in dealing those sorts of trauma and other issues that are facing Nunavummiut today.
Is that all, Ms. Angnakak?
Moving on. I remind members that we’re on page H-6, in Inuktitut C-6.
Moving on with the next name on my list. Mr. Savikataaq.
As the minister is aware, addiction is a major problem and a big issue in Nunavut.
Over the years, the Nunavut government has considered a number of different options for addressing addiction issues in the territory. In 2012-13, your department launched a 28-day Mobile Addiction Treatment Pilot Programming in Cambridge Bay.
The program was evaluated in 2013-14. Was the program a success?
If so, will it be delivered again in another community or are other initiatives being considered?
In regard to addictions, (interpretation ends) health works with local communities to develop and deliver addictions treatment projects in order to build knowledge about which service models are most effective in Nunavut.
Annually health makes $1.1 million in funding available to hamlets for the delivery of drugs and alcohol services.
The Cambridge Bay pilot project that the member is referring to, I believe, was a success and will be continued.
Currently, there are beds in the facility. Treatment is made available for those in the community, as well as the surrounding area.
There are day clinics as well.
At the current time, we are looking at the model and reviewing it. Moving forward, we’re hoping to set up a similar program in a community, such as Rankin Inlet.
Has the minister given any thought to having a stand alone addictions treatment facility somewhere in Nunavut?
We’re not looking at one individual place in a community where a lot of people can go.
We’re moving forward looking at Mobile Treatment Centres within the communities, themselves.
Can the minister just explain to us what a Mobile Treatment Centre is?
Just so we’ll know.
With your permission, I’ll ask my deputy minister, Ms. Keenainak, to answer the question.
Chairman (interpretation): Thank you. (interpretation ends) You have my permission.
The Mobile Addictions Treatment Program, the model that was used and evaluated… .
We’re taking our lessons learned, what worked and what didn’t work. We’re also looking at other models. I know that there’s a model in Northern Quebec.
I know that there’s another model from Labrador as well that we’re also looking at as to how we can tailor that for Nunavut.
The Mobile Addictions Treatment Program is where it’s in the community and they’re able to have the services. They’re not in an institution or is locked up. There’s an opportunity for family members to participate in a client’s treatment because we know that addiction also affects other family members.
Addictions should be more holistic. That’s the kind of approach that the Mobile Addictions Treatment Program is.
As we indicated, the mobile addictions pilot project was from a southern jurisdiction and that’s why we’re looking at models like it to make it more relevant for Nunavummiut.
Mr. Savikataaq: Thank you, Mr. Chairman. Just more on the mobile thing, is it like a facility where people go and stay, like spend the night there, or people go there for the day and then go home?
I believe there are 12 beds there and there are maybe four or five currently that are in the facility full time and several more that have day clinics.
I can get the exact numbers to the member at a later time.
On a different topic here, the budget for community health centres is projected to decrease in 2014-15. What accounts for the decrease and will any services be reduced as a result of the decrease?
I didn’t quite understand his question. I would like to ask the member what it is that is decreasing.
If you can clarify that, Mr. Savikataaq.
In your business plan on page 103 under Community Health Centres, the budget for 2013-14 was $36 million, I guess it is, and $299,000, and for 2014-15, it’s $35,298,000, a slight decrease. I just want clarification if any services will be reduced.
Chairman (interpretation): Thank you for that clarification, Mr. Savikataaq.
I would like to have our finance controller, Johan Glaudemans, respond to the question.
Mr. Glaudemans.
Mr. Glaudemans: Thank you, Mr. Chairman.
The budget for 2013-14 would have received additional funding in the supplementary appropriation that would have been a one-time amount.
The department, from time to time, requests additional funding for areas during the year where there’s either under-funding or overspending, depending upon how you look at it.
The current amount for 2014-15 is the initial main estimate.
It is very possible that during the year, we will come back to the Legislative Assembly with an additional funding request, but we do attempt to limit that.
It is basically demand-driven.
Chairman: Thank you as well, Mr. Glaudemans.
One of your department’s priorities for 2014-15 is to improve the strategic management of federal program dollars administered by your department.
Can you explain what kind of improvements you envision? Will there be more federal money available for community-based or issue-specific initiatives?
Chairman: Thank you as well, Mr. Savikataaq.
Hon. Monica Ell: Thank you.
Health will continue to develop more programs to take advantage of federal spending priorities in order to effectively use federal funding to provide the best possible health care for Nunavummiut.
Chairman: Qujannamiik Hon. Minister.
Mr. Savikataaq: One of your department’s priorities for 2014-15 will be to enhance long-term care service. Can you describe what kind of enhancements are being considered and whether any new facilities will be built?
Chairman: Qujannamiik, Mr. Savikataaq.
I have already answered that question.
We’ll go to a different topic.
Information from appendix A-IV-2 of the draft main estimates indicates that Non-Insured Health Benefits funding will be decreased for 2014-15, despite an increased in the revised estimates for 2013-14.
How is the amount of federal funding provided for the Non-Insured Health Benefits Program determined?
I just want to make sure that I’m on the right page.
The original budget that we were told was $27,750,000 and depending on the amount of Inuit and First Nations, mainly Inuit in Nunavut, go out for services.
We do flag to the federal government the additional costs and then they do provide the additional costs to the department.
For this fiscal year, we’re projecting a slight increase but again during the year it depends on the number of NIHB clients that we have to charge back then we would be dialoguing with them, which we do regularly, to make sure that they’re aware if it’s going to be higher.
Then there will likely be an adjustment depending on how things go.
But that’s the initial amount that we’ve been told by the Department of Health, Canada.
Chairman: Qujannamiik, Ms. Keenainak.
Let us proceed, Mr. Rumbolt, on page H-6 please.
In my question I need to go back a bit in history in order to get my point across today.
On March 1, 2013, which was 15 months ago, the minister of the day announced and I quote, “$600,000 to increase the staff compliment of community health nurses of three-nurse stations to four-nurse stations in three communities in the Kivalliq region.”
On March 4, I asked the minister of the day which communities will be going from a three-nurse station to a four-nurse station.
I was told it was Coral Harbour, Repulse Bay, and Sanikiluaq, which was welcoming news to my community.
Several weeks ago, I was at the health centre and I asked a nurse where the fourth nurse was, and she did not have any information about it.
On May 23 of this year, I asked a question in the House to the Minister of Health, and my question was, “How many full-time nursing staff positions currently exist at the Sanikiluaq Health Centre?”
Her reply to me was that Sanikiluaq has three full-time nurses.
Can the minister clarify today which statement is true, the statement from 15 months ago or the statement in the House a few days ago?
In 2013, the department received authority and funding for three nurse positions in the Kivalliq region, one for Sanikiluaq, one for Coral Harbour, and one for Repulse Bay.
All three new positions have been filled with full-time employees.
As well, the Sanikiluaq Health Centre staffing has been increased from two nurses to three nurses as of April 2013.
In addition to the significant increase in workload in Sanikiluaq, through reallocation of existing resources, the department has increased the nursing staff to four nurses by hiring a casual nurse to fill the fourth position.
What she is saying, then, is that 15 months ago, what the minister stated in the House was actually not correct, we were not a three-nurse station and that we were a two-nurse station.
You just mentioned that we would be up to four nurses, but one of the nurses is a casual.
Does that mean we will now be a three and a half nurse station or will we be at four full-time positions in our community?
Chairman: Thank you, Mr. Rumbolt. Minister Ell.
I believe there is a confusion with your supervisor of health programs, who is also a nurse.
Just for clarification, the half-time position nurse is the head nurse who does other duties and she is a part-time nurse seeing patients.
Hon. Monica Ell: Thank you, Mr. Chairman. I’m going to have my deputy minister, Ms. Keenainak, answer the meaning of a casual nurse.
Sanikiluaq does have a supervisor of health programs, which is called a SHIP, and three community health nurses, and I believe there is also a mental health nurse in there.
Currently, the mental health nurse position is vacant, so it is going out for competition. One of the positions has not been filled permanently and is being filled through casual means.
We bring in casuals to make sure that the health centre in Sanikiluaq has that complement.
Depending on staffing issues and things like that, there may be occasions that the full complement is not there, but the complement for the health centre is one SHIP plus three community health nurses and a mental health nurse.
As of today, are we fully staffed at that health centre?
Do you we have the SHIP? I know she is there. Do we have three full-time nurses in place plus that casual?
I will have Ms. Keenainak answer the question.
Ms. Keenainak: There is one position that is not permanently filled and is filled through casuals. The mental health nurse position just became vacant recently and is currently being covered by agency nurses when we’re not able to hire a casual first.
With the position that’s been filled as a casual and using agency nurses, what are the stumbling blocks from keeping you from filling this to a full-time position and not use casual?
I’ll have Ms. Keenainak answer the question.
The department is planning on advertising that position in the near future. We’re hoping to fill that position by the fall.
Hopefully it will go for advertising fairly soon, but in the interim we are filling the position on a casual basis to make sure that there is coverage and to make sure there are adequate nurses in Sanikiluaq.
I know our present nursing station, there are only three apartments in there and if we’re going to a fourth nurse there will be a requirement for staff housing.
Has your department approached the Nunavut Housing Corporation for staff housing for this position?
At this moment I don’t have that information but we can double-check to make sure that a housing request has been made for that particular position.
Nursing positions are considered priority one when it comes to housing, so that is something we can definitely get back to the member on.
I appreciate the minister’s staff in clarifying the issue with the nursing situation in Sanikiluaq.
Back to my question in the House on May 23 when Ms. Ell responded to my question about nursing requirements in my community she also mentioned a psychiatric nurse.
Are there plans to put a psychiatric nurse in the community of Sanikiluaq too?
What I was talking about was the mental health nurse and that is the position that we just talked about.
With the vacant mental health position, when do you expect to have that filled?
We’ve answered that question previously. I’ll say it again, Ms. Keenainak said, “in the fall.”
If you’ll indulge me I’ll make a brief statement before I get to my question.
As medical travel is a part of this budget, I’m sure other members, of my colleagues, will have questions regarding it.
I’ve asked questions previously and after this comment I will forgo some questioning.
The minister has already committed to try and alleviate some of the stresses on this budget and traditionally there have been repeated requests for additional funding of that nature.