EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
In this budget item alone, there’s almost $60 million in medical travel, almost $54 million in out-of-territory hospital costs in addition to mental health and addictions costs, long-term care costs that are spent outside the territory, elder care services and youth care services that are spent outside of the territory.
I went on record numerous times in this House on the lack of infrastructure and the need to provide these services to Nunavummiut in Nunavut.
I just want to really encourage the minister to work within her department to recognize that that is a lot of money being spent outside of this territory.
I acknowledge that we can’t pull these infrastructure projects on an overnight basis. That’s why I won’t ask any further questions on it.
I just wanted to go on record, once again, on my desire for your department to work towards maintaining those services and creating those services in Nunavut.
I just have a couple of brief questions within this category, Mr. Chairman.
I have noted, with some interest, there are a number of Acts that are up for review by your department, and it’s a lot of pressure on your policy staff.
In the priorities for 2013-14 alone, there are two Acts that are up for amendments. As it’s stated from the status, that the department developed a legislative proposal for both those Acts: the Mental Health Act and the Vital Statistics Act. We have yet to see the legislative proposals.
Is there going to be a timeline from the department on when we will be able to advance those projects?
Chairman (interpretation): Thank you, Mr. Hickes. Minister Ell.
Hon. Monica Ell: Thank you, Mr. Chairman. I did answer this question the other day with another member asking the same question. I’ll read out the legislative agenda once again.
We’re hoping to do a small legislation proposal with a larger legislative proposal through the years for the fall of 2014 the Vital Statistics Act; the Mental Health Act for the fall of 2015; the Public Health Act in the winter of 2015; an Unregulated Professions Act by the spring of 2016; and Medical Professions Act and Regulations by the spring of 2015; and the Health Privacy Legislation Act by the fall of 2017.
Mr. Hickes: Thank you, Minister Ell. Thank you for clarifying that.
It was me that asked the question the other day. I was paying particular attention to two specific Acts.
Mr. Chairman, also in the priorities under 2014-15, there is work towards the implementation of an infection prevention and control program in order to protect patients and staff from infectious diseases in Nunavut healthcare facilities.
What are the risks of not having this program in place?
I don’t have the specifics in front of me.
I’ll see if Ms. Keenainak has that answer.
Chairman (interpretation): Thank you. Ms. Keenainak.
Part of the infection prevention and control program is to protect patients and healthcare workers from infections.
I think we’ve heard in southern jurisdictions where patients that have gone to the hospital and then get sick with something else. So the IPAC program, as we’re calling it, would include standards and protocols for separating infectious patients from others, for the proper cleaning of healthcare facilities, and for the use of protective equipment. That would be making that standard in all of our health facilities.
I know that work has progressed whether has been a manual developed for our janitorial staff in all the communities just to standardize how to clean bodily fluids, and things like that.
On the standardized things as the kinds of cleaning supplies in all our health facilities, those are the kinds of things that the department is working on this particular task.
Let me remind members that we are on page H-6.
Mr. Mikkungwak continuing.
A few days ago I had ask a question relating to the non-insured health benefits in relation to the eligible Inuit.
I know that an answer was provided however, I would like a specific answer.
For example, the MLA from Gjoa Haven we are Inuit. Would we be treated the same way?
What does eligible Inuit? What do you mean when you say eligible Inuit? Are some Inuit not eligible?
Hon. Monica Ell (interpretation): All the Inuit in Canada, wherever they may live, whether they live in the provinces. Any person who is recognized as an Inuk and considered to be First Nations people, those are the people referred too.
Chairman (interpretation): Thank you for the clarification, Minister.
Mr. Mikkungwak (interpretation): I thank you, Mr. Chairman, and the minister because it is now clear.
The next question then, moving on to some other subject in relation to the business plan, on page 103, the first one where it says professional practice, it states in the last part, (interpretation ends) “also manages accrediting, registration and licensing of health care providers.”
My question here is: how many nurses in Nunavut are being licensed for this?
Chairman: Qujannamiik, Mr. Mikkungwak.
I don’t have that at my fingertips. I can provide that to the house through you, Mr. Chairman.
Chairman (interpretation): Thank you. We will get that answer once it has been drafted.
If possible, could there be a breakdown regionally? For example in Baker Lake, our population increased and I think we need to have six nurses. I’m wondering if all those six have been licensed.
I’m just making a statement.
However, the next one in relation to the mental health and addictions section, having dealt with it for over a 14-year period where I worked.
In the Third Assembly... . My question is in relation to the mental health and addictions framework was dealt with by the third assembly.
They were thinking that those who deal with those things, the staff that is.
Some of them would have been working at the hamlet municipal level began to work within the government civil service.
Is that still in use?
Hon. Monica Ell (interpretation): Perhaps if the question could be drafted once again. Could you clarify your question?
Chairman (interpretation): Mr. Mikkungwak
Mr. Mikkungwak (interpretation): Thank you, Mr. Chair.
Let me speak in English then. (interpretation ends) At the time of the Third Legislative Assembly, the mental health and addictions framework was thought at that time.
I was an employee back then for 14 years.
Part of the mental health and addictions framework strategy was to have the community-based addictions counsellors who were employed by the hamlets by respective communities would become Government of Nunavut employees providing that service still but would become Government of Nunavut employees.
Has that been followed through?
Chairman (interpretation): Thank you (interpretation ends), Mr. Mikkungwak.
I am not too familiar with this, but we can review that and take a look at it and provide an answer at a later time.
Do I understand then that you will be coming back to us provide an answer to the Legislative Assembly?
We will endeavour to understand what the status of the decision we were able to get a clarification and we will make an advisement.
Chairman (interpretation): Thank you (interpretation ends), Minister Ell.
Mr. Mikkungwak: Thank you, Mr. Chairman. I thank the minister for that response.
Moving along, under medical transportation, I know this is a very sensitive issue regarding the medical travel policy.
Regarding medical travel policy, the question I have is the majority of my constituents who go on medical travel and who are going to be undergoing surgery once they get to Winnipeg, Manitoba have been advised why do you not have an escort, and considering the type of surgery, after your surgery is complete you cannot carry anything over 10lbs, and the doctors question the client.
Has that issue been taken into consideration?
Medical patients that are traveling for medical reasons all have different and varying reasons for traveling out-of-territory or to health centres and it would be a case-by-case basis.
We would have to deal with it on a case-by-case basis, and I would like Ms. Keenainak to explain further about a meeting that just took place recently.
There was a recent meeting that took place the week of May 5 in Rankin Inlet and various players were at the table, like Health Canada, WSCC, the Department of Finance, and the Department of Health, which included directors, case monitories, finance managers, insurance managers, and medical travel employees.
We discussed the policy to make sure that it was understood and that it was applied consistently.
Issues that we included were ones I have raised to staff to make sure that it is being consistently applied and that we rely on clinical advice when a patient needs an escort or not, especially before or after surgery.
We are continuing to have discussions among staff across the territory to make sure that the policy is being consistent, especially when something like that happens.
I guess the reason why I pointed that out is because a doctor who is going to perform surgery has an idea of your physical limitations after surgery.
I think that takes merit on its own considering the fact that he is the one that is performing the surgery and he is fully knowledgeable about his practice.
I just have one additional question, again, going back to professional practice.
How often is that monitored across the territory considering there are so many communities within our territory?
Chairman (interpretation): Thank you, Mr. Mikkungwak. (interpretation ends) Before I turn it over to the hon. minister, may I remind myself, as the Chair, and remind all members here that for the benefit of everyone listening on TV or radio, please keep in mind that we need to cognizant of our interpreters.
They’re having to keep up when we speak.
With that, Qujannamiik. Hon. Minister.
I would ask Ms. Keenainak to answer that question.
Chairman (interpretation): Ms. Keenainak.
All nurses need to be licensed in order to work as a nurse in the territory. When a letter of offer is made to a nurse, the conditions in their letter of offer says that you need to be registered and licensed within the territory.
A nurse needs to go through the Professional Practice Office to go through the licensing process to be licensed. That will confirm. If they’re not licensed, then they cannot work as a nurse in the territory.
If there are issues with a nurse, in terms of licensing complaints, those would be brought forward to the Registered Nurses Association from the NWT and Nunavut, who investigate certification, and so forth, but they must be licensed.
We work with the Nursing Association, as well with the Professional Practice Office.
In order to work, all nurses have to be licensed in the territory.
I thank Ms. Keenainak for the response.
I still have questions concerning this issue.
In Baker Lake the population is approximately 2,400. Also very close to the community there is a mining camp that is happening.
With that mine close to the community of Baker Lake, we’re supposed to have six nurses in our community. We’ve never had six nurses.
During the flu season, I understand fully that the nurses get busy.
When many people get the flu, the nurses get really tires. Sometimes when people call to the nurses, sometimes the nurses just hang up the phone. Patients get scared to call the nurses in some days.
Sometimes there is an argument between the nurses and patients. It’s not good.
How do you deal with that kind of an issue?
This week when the member was asking in regard to the nurses in his community, I responded to his question at that time.
In English we are on page H-6, and in Inuktitut C-6.
In regard to my colleague’s question I need some clarification. In the business plan for O&M, under Professional Practice, it also manages the credentialing, registration, and licensing of health care providers.
The Registered Nurses Association of Nunavut and the NWT, can you elaborate further as to how they work with the NWT and Nunavut unions?
I don’t have that information in front of me so therefore I cannot respond to that question.
Mr. Joanasie (interpretation): Does the department provide licensing to the health care providers or is it the registered nurses association that provides licensing? If the minister can elaborate about that.
I’ll have Ms. Keenainak respond to that question.
A nurse needs to be registered as a nurse to the registered nurses’ association and they have to meet their criteria as a registered nurse.
The professional practice ensures that they’re licensed to work as a nurse in the territory.
Chairman (interpretation): Thank you, Ms. Keenainak, for the explanation.
Mr. Joanasie (interpretation): Thank you for your response to my question.
Moving on, home care; I have a question about home care.
I believe home care is under this line item.
I need further clarification on how many home care workers do we have in my constituency of Kimmirut.
If the department officials have that information.
I can only say that in Kimmirut, for the person-years, there are two person-year nurses that are permanent and at times there’s one casual nurse.
For Kimmirut home and community care services, they have not changed. Home care is still available.
If home care needs in the community increase and additional supports are required, arrangements are usually made that meet the identified assessed need.
Anyone can make a referral or request for home care services. Once a referral has been received, a nurse will do an assessment to determine the person’s need.
Chairman: Qujannamiik, Minister Ell.
The referrals that she mentioned, who do they refer that individual to?
I want to move on to the medical transportation. I believe it’s a proposal for $59 million.
Does that include the boarding homes, such as Tammaativvik? Is that line item including Tammaativvik?
Can you give us a clarification? Minister Ell.
The funding line item that the member identifies is funding from NIHB.
Chairman (interpretation): Minister Ell, Mr. Joanasie was asking in this proposed $59 million, under medical transportation, I believe he was asking whether the O&M for medical transportation is included in this proposed line item.
This line item of $59 million is for medevac services and scheduled airline medical transportation.
Chairman: Thank you for the clarification, Minister Ell.
Mr. Joanasie (interpretation): For the proposed medical transportation, this line item has increased from 2013-14.
I was wondering what the historical estimates for this line item has been in past years, to ensure that budgeting for it is accurate for medical transportation.
These estimates are based on historical costs from the past with a 6 percent average annual growth.
Chairman (interpretation): Thank you for the explanation.
We are on H-6.
Department of Health, branch summary, health care service delivery.
Total… Mr. Mikkungwak, did you raise your hand?
Mr. Mikkungwak (interpretation): Thank you, Mr. Chairman for allowing me to ask another question.
I have one question. (interpretation ends) You can rule me out of order. I just have one question here.
Mental health and addictions, at the Third Assembly when it was, I guess we could say divorcing from Health, would it not have been more suited to tie in with Family Services, or what was the reason why it stayed with Health?
I cannot answer that question.
Chairman (interpretation): Thank you, Minister Ell. (interpretation ends) If you want to stick to your word, you have asked your one question.
(interpretation) We are on page H-6.
Health. Branch Summary. Health Care Service Delivery.
Total O&M, to be Voted. $257,890,000.
Go back to page H-3.
Department Summary. Health. Detail of Expenditures.
Total Operations and Maintenance, to be Voted. $298,947,000.
Are we agreed that the Department of Health is concluded?  Some Members: Agreed.
Chairman (interpretation): Thank you. Thank you, (interpretation ends) Hon. Minister, (interpretation) for we are concluded with your department.
If you have any closing remarks, you now have an opportunity to make them.
From questions posed this week, in my closing comments, I would like to clarify some of the questions that were asked, such as the environmental health officers who inspect public housing and rental units when a complaint is received from a tenant or landlord.
The question posed was, “Do they include private homes?”
Environmental health officers (EHOs) rarely inspect privately owned homes and only do so upon the request of the homeowner.
These inspections are for advice only, as EHOs have no regulatory authority over privately owned homes.
The environmental health officers conduct inspections relating to drinking water and sewage systems. EHOs inspect reservoirs, water sources, pumphouses, treatment and distribution of drinking water, water trucks and their operations, sewage lagoons, and landfills.
EHOs have inspected a total of 414 facilities across the territory since April 1, 2013; 91 in the Kitikmeot, 118 in the Kivalliq, and 205 in the Baffin region.
There are five environmental health officer positions, one in the Kitikmeot based in Cambridge Bay, one in the Kivalliq based in Rankin Inlet, and one in the Baffin based in Pangnirtung and two in Iqaluit.
Staffing competitions are in progress for vacant positions. These positions are in Rankin Inlet and in Pangnirtung that recently became vacant. The staffing process is underway.
In terms of the Baffin dental contracts, they are being met. The terms of the Baffin dental contract are being met.
The paediatric oral surgery days provided in Churchill were over and above any service days in the Baffin dental contract.
Children on the waitlist for dental surgery treatment under general anaesthetics as of May 22, 2014 total in all regions is 574.
The administration of the boarding home contract monitoring, the boarding home contracts contain clauses that obligate the contractor to maintain a safe and clean environment. The contractor must maintain a hygienic environment to a standard acceptable to the Department of Health, maintain a schedule of operations and preventative maintenance activities to ensure proper operation of the facility, and meet the health and safety standards of the jurisdiction where the boarding home is located.
Boarding homes are regularly inspected by environmental health officers and workers, health and safety staff who are employed within the respective jurisdictions. The department is notified of any deficiencies and corrective action is taken.
In 2013-14, there were 17,082 returned medical trips taken, less than one percent of all medical travel bookings experienced medical appointment booking difficulties.
In closing, I would like to thank my staff, Deputy Minister Rosemary Keenainak, and Corporate Director, Johan Glaudemans, and all the questions that members raised.
I will follow-up on some of the comments provided this week and thank all members. (interpretation) Thank you.
As Chair, I would like to thank you for the promise that you would get back to us with the questions that we had.
Thank you for giving us a quick turnaround by responding to our questions.
Sergeant-at-Arms, if you can escort the witnesses from the witness table.
We will be dealing with Community and Government Services.
Just before we start on that department, we will take a 10-minute break.
>>Committee recessed at 16:47 and resumed at 16:58
Bill 02 – Appropriation (Operations & Maintenance) Act, 2014-2015 – Community and Government Services – Consideration in Committee
Chairman (interpretation): We can now proceed to the Committee of the Whole.
We are going to be dealing with the Community and Government Services.
Just before we go in page-by-page, Minister Sammurtok is already at the witness table.
I would like to ask Mr. Sammurtok if he has officials that he would like to sit with.
Hon. Tom Sammurtok (interpretation): Yes.
Chairman (interpretation): Does the committee agree that the Hon. Minister’s officials proceed to the witness table?
Sergeant-at-Arms if you can assist the staff of the minister.
Minister Sammurtok, for the record and for our information, can you introduce your officials?
Today, we have Deputy Minister Roy Green on my right, and to my left is Corporate Controller for our department, Gershom Moyo. Thank you.
Chairman (interpretation): Thank you, Minister Sammurtok. (interpretation ends) Mr. Green and Ms. Moyo, welcome to the witness table. (interpretation) Continuing on.
Mr. Minister of you have any opening remarks, you can proceed.
Hon. Tom Sammurtok (interpretation): Thank you, Mr. Chairman. (interpretation ends) I am pleased for this opportunity for appear before the Committee of the Whole to review the Department of Community and Government Services 2014-15 main estimates and business plan.
We have had a very productive and informative discussions at the standing committee phase. I always welcome the opportunity to clarify any issues and concerns my colleagues may have in regard to the work we are undertaking on behalf of the GN and Nunavummiut.
Mr. Chairman, the Department of Community and Government Services continues to manage programs and services for local governments, government services, petroleum products, procurement, protection services, informatics, property and asset management and sport and recreation.
When the Petroleum Products Division revolving stock is included. CGS has an overall annual budget of $420 million, with nearly 370 positions spread out across Nunavut.
Our projected budget includes a net increase of $1.12 million over last year’s main estimates.
The Petroleum Products Division continues to manage the fuel provision mandate for the GN. The cost to purchase fuel has increased over the last two years. As a result the previous retail prices were no longer sustainable. The increase in the retail price to allow PPD to recover the increases in its operating costs.
Nunavut’s retail price still remain comparable and lower than other Canadian jurisdictions.
On April 1, 2013, CGS rolled out the new Municipal Funding Program. This program was developed with extensive input from Mayors, SAOs, NAM, and NAMA.
The program formula provides transparency on how the department funds municipalities. The program has been widely welcome by municipalities and feedback has been positive.
The Funding Formula is subject to review every three years.
This year CGS will provide $45,550,000 in funding to communities under this program, up from $45,175,000 last year. This slight increase is to fund additional O&M on municipal infrastructure completed last year and turned over the municipalities.
CGS continues to strongly support the activities of the Municipal Training Organization.
MTO has been providing much needed training for municipal employees for over ten years now. The training provided by MTO allows municipal employees to gain skills that assist them in delivering services to residents with training costs that are low and affordable to the municipalities.
CGS remains MTO’s largest funding partner and are pleased to continue our funding level to MTO.
Iksivautaaq, water licensing and compliance has been a long standing issue for Nunavut municipalities.
The department has been working diligently with municipalities to ensure that water licenses are renewed and that communities comply with the conditions of these licenses.
We have included funding in our estimates this year to allow the department to hire a manager to coordinate this process and work jointly with regional municipal engineers to provide support and training to municipalities in renewing their licenses.
We are now approaching two years since sports and recreation returned to Community and Government Services.
The division just completed its support activities for Team Nunavut’s participation at the 2014 Arctic Winter Games in Fairbanks, Alaska. It has been a very successful and enjoyable event for our athletes. It gave them a great opportunity to participate in their respective sports and showcase their culture on an international level.
Under our agreement with the Western Canada Lotto Corporation, sports and recreation added a third lottery terminal this year and will add one more terminal again this year.
Negotiations are currently underway with WCLC to see the program expand to four additional Nunavut communities in 2015.