Agreed.
Committee, we will begin on page 3 of the Department of Health and Social Services, Health and Social Programs, not previously authorized, $2,797,000. Does the committee agree?
Agreed.
Supplementary Estimates (Operations Expenditures and Borrowing Authorization), No. 3, 2024-2025, Department of Health and Social Services, out of territory services, not previously authorized, $24,715,000. Does the committee agree?
Agreed.
Supplementary Estimates (Operations Expenditures and Borrowing Authorization), No. 3, 2024-2025. Department of Health and Social Services -- What? Oh, sorry, -- I thought I heard everybody say agree. Okay, Sorry. Member for Great Slave.
Thank you, Madam Chair. For out of territory services in the amount of $24,715,000, can the Minister speak to the over-expenditures and what is an average amount in any given year? Thank you, Madam Chair.
Minister of Finance.
Thank you, Madam Chair. An average -- Madam Chair, I will see if comptroller general has that. I mean, the amount that is -- yes, let me see if the comptroller general has that. I don't know that we have an average, Madam Chair. I mean, typically the amount that's budgeted would be -- I mean, I venture to say that that may be based on an average but, again, that's not how -- I don't have that kind of a number in front of me. Thank you.
Member for Great Slave.
Thank you, Madam Chair. Yeah, and I can appreciate that perhaps that's just a random ask, but I guess the point behind my question is it's not an insignificant amount of money. Obviously, our residents need to have out of territory services; obviously, we budget for that. Perhaps a better question would be, does the department have substantiation or trends that they're noticing in terms of increases in this regard? Thank you, Madam Chair.
Minister of Finance.
Thank you, Madam Chair. It is indeed a difficult area. There certainly is some work being done in this respect. There's -- you know, obviously the volume of residents who may require this care is one of the areas of driver, but also the type of care that is being required. And then the costs of that care and the cost of specialized medical care, certainly in the last five years or so has gone up faster than what it had been previously, but also there's the costs that may be involved depending on, you know, again, some of the other parameters of just where they may be. Different facilities and services in the southern jurisdictions have different requirements for costs. So all of that I can say is being looked at right now as part of broader system sustainability and broader reviews to determine if there are areas that there could be some streamlining, including everything from the contracts with the individual providers to travel that takes place right now, both bringing residents back this way or we're sending families down south, how that gets approved, how it does approve just to needs care. So, yes, I can say that that is being looked at and that some of that is -- will hopefully come forward in the not too distant future. Thank you, Madam Chair.
Thank you. Member for Great Slave, do you have a follow-up?
Yes, I do. Thank you, Madam Chair. So for this line item, can the Minister explain if this also includes the folks who are living permanently in institutions in other jurisdictions for their care? Thank you, Madam Chair.
Minister of Finance.
No, Madam Chair.
Thank you. Any further questions? Okay. Supplementary estimates, operations -- oh, I didn't see her. Member for Yellowknife North, sorry.
Thank you, Madam Chair. So the expenditures that we're looking at here, the operational expenditures, are allocated to be under Department of Health and Social Services, but I understand they must be related to the services being provided by the NWT health authorities. And so we know that the budget of the health authority, at least as of March 2025, we can see the accumulated deficit of the NTHSSA at the end of fiscal year -- or at the end of March 2025 was over $300 million, and it's been growing each year. Is the extra supplementary $27.5 million that we're looking at here -- does that impact how the health authority deficit is recorded in any way, or is this -- yeah, maybe I'll just leave it there for my first question. Thank you, Madam Chair.
Thank you. Minister of Finance.
Thank you, Madam Chair. So no, Madam Chair, this is not. And there's a couple of different line items that we see in the course of reviewing the Department of Health and Social Services broadly, including where they would put money to support the authority. But this is where if someone who has Northwest Territories health care and they go anywhere outside of Northwest Territories, we are billed back. So this is out of territory hospital medical services. It's not residents who are permanently in other facilities or who may be residing in other facilities, you know, sort of longer term for specialized treatment or say for addictions treatment. For example, this is really it's for the medical expenses, hospital visits, physician services that would be provided. So by necessity, this is actually when services are not provided by the health authority here that we pay back. Similar to if someone who has an Alberta health care or BC health care card comes here, we bill them. Thank you, Madam Chair.
Thank you. Member for Yellowknife North, do you have a follow-up?
Yes, thank you, Madam Chair. And so to confirm, though, I mean, I know we're looking at -- the second line item is out of territory services which could include seeing physicians or medical professionals down south, and the first line item is health and social programs occurring here in the territory. Either way, would the Minister agree that to a large extent, the expenses that are occurred for sending people out of the territory are a direct or indirect result of choices made about services that can or cannot be provided by the health authorities in the territory? So in fact the budgets are related? Can the Minister -- I guess what I'm asking is, I mean, theoretically -- if these budgets are considered to be totally separate, theoretically the health authority could resolve its deficit by just cutting a bunch of services here and having residents have to go down to Alberta, and other jurisdictions, to access those services, but all it's really doing is shifting the costs from within the health authority budget to something that we would often have to see here in supplementary appropriations. So what mechanisms are there to actually connect the budgets and the decisions that are made where patients can access services to ensure that we're not continuing just shifting problems from one pot to another and inevitably ending up here in supplementary appropriations as, you know, unplanned-for costs? I know that's sort of a rambling and unclear question, but I wonder if the Minister could comment on that. Thank you, Madam Chair.
Thank you. Minister of Finance.
Thank you, Madam Chair. So, Madam Chair, there are -- there's a cost associated to when someone is on medical travel as opposed to when someone may be already down south for some other reason or, you know, students for instance, who are down on SFA but who are still considered Northwest Territories residents. You know, there's a number of people who may be down south for one reason or another. And some of this may be the medical travel that I gather maybe is what the MLA is getting at, but not necessarily all of it. So I can say that out of territory services broadly is, indeed, an area that the system sustainability unit is looking at, but it is not exclusively a matter of saying that this is all entirely medical travel related in the sense of where someone who can't get something in the North is necessarily going down south. Some of it is people who are down south for other reasons, who are choosing to go down south for other reasons, who are, you know, as I say students, you know, a number of different examples. So some may be related to medical travel. I don't necessarily have that kind of a breakdown in front of me to the extent, if at all, that it is. But some is not. So, yes, Madam Chair, I -- yes, anything that's out of territory, there's certainly some cost drivers but as far as breaking that down, it's not as easy as just saying that this would eliminate all of the budgetary deficit in the authority by assuming that everyone went down south. Yes, I don't know that it -- I don't think that that blanket statement can be made. Thank you, Madam Chair.
Thank you. Member for Yellowknife North, do you have a follow-up?
Thank you, Madam Chair. Perhaps I'll just conclude by asking, do we have a target or a goal for reducing the amount of supplementary appropriations that seem to come to us every single round for, you know, extra operational expenditures for health and social services? Has the department, has the Department of Finance set a realistic goal for when these asks are going to be reduced or eliminated and how we might actually achieve that? Thank you, Madam Chair.
Thank you. Minister of Finance.
Thank you, Madam Chair. Madam Chair, we are as a government working towards a position where right now the health authority does run a deficit budget, most -- well, all departments and agencies do not. So we are trying to put ourselves into a position where the health and social services authorities would be in the same position, namely, not running any form of deficit budget. But before we do that, we are wanting to do the work that's happening both within the authority of the public administrator to determine the appropriate complement of staffing, for one, but also work that's happening in the system sustainability unit to do the necessary data collection to see things like medical travel and whether or not there's some efficiencies to be found, then hopefully come up with what will be an effective number and meaningful number so that the authorities can still function and provide services that they need to. Thank you.
Thank you. Any further questions? Does the committee agree?
Agreed.
Supplementary Estimates (Operations Expenditures and Borrowing Authorization), No. 3, 2024-2025, Department of Health and Social Services, total department not previously authorized, $27,512,000. Does the committee agree?
Agreed.
Members, there is a schedule on page 4 that details borrowing authorization and on page 6, that details the supplementary reserve impact. Are there any questions about these schedules?
Seeing no further questions, please turn to page 5. Government of the Northwest Territories Supplementary Estimates (Operations Expenditures and Borrowing Authorization), No. 3, 2024-2025. Department of Finance, revised borrowing authorization, total government borrowing authorization, proposed adjustments, $5,954,000. Does the committee agree?
Agreed.
Thank you, committee. Do you agree that you have concluded consideration of Tabled Document 386-20(1), Supplementary Estimates (Operations Expenditures and Borrowing Authorization), No. 3, 2024-2025? Member for Inuvik Boot Lake.
Thank you, Madam Chair. Madam Chair, I move that this committee defer further consideration of Tabled Document 386-20(1), Supplementary Estimates (Operations Expenditures and Borrowing Authorization), No. 3, 2024-2025, at this time. Thank you, Madam Chair.
The motion is in order. To the motion.
Question.
Question has been called. All those in favour? All those opposed? The motion is carried. Consideration of Tabled Document 386-20(1), Supplementary Estimates (Operations Expenditures and Borrowing Authorization), No. 3, 2024-2025, is deferred.
---Carried
Thank you, Minister, and thank you to the witnesses for appearing before us. Sergeant-at-Arms, please escort the witnesses from the chamber.
Committee, we have agreed to consider Tabled Document 387-20(1), Supplementary Estimates (Infrastructure Expenditures), No. 2, 2025-2026. Thank you, Minister. Does the Minister of Finance wish to bring witnesses forward?
Yes, please, Madam Chair.
Does the committee agree?
Agreed.
Thank you. Sergeant-at-Arms, would you please escort the witnesses into the chamber. Thank you. Would the Minister please introduce her witnesses.
Thank you, Madam Chair. Madam Chair, back again, on my left is Bill McKay, the deputy minister of the Department of Finance. On my right, Mandi Bolstad is the deputy secretary to the Financial Management Board.
Committee has agreed to forego opening comments and general comments. Does the committee agree to proceed to the detail contained in the tabled document?
Agreed.
Committee, we will begin with page 5 with the Department of Infrastructure, Supplementary Estimates (Infrastructure Expenditures), No. 2, 2025-2026. Department of Infrastructure, operations expenditures, energy and strategic initiatives, not previously authorized, $12 million. Does the committee agree.
Agreed.
