Thank you, Mr. Chair. Just to quickly follow up on my colleague's question from Mackenzie Delta. On the facility-based addictions treatment, we also consistently year over year see money come forward in our supplementary estimates for many millions of dollars required to, you know, top up the money we're allocating for facility-based addictions treatment, and in the supplementary estimates that were just tabled earlier today, we're asked for an additional $5.87 million for facility-based addictions treatment. So that's like more than double -- almost triple, like, the base amount that we're actually budgeting for facility-based addictions treatment. Are we to understand that this number here is what the feds are willing to pay us for but we continue to spend the money anyway and we just keep bringing it back in supplementary estimates, or what's the rationale for not just increasing the amount in the actual budget when we know we're going to need many millions more to meet the demand for facility-based addictions treatment? Thank you, Mr. Chair.
Okay, thank you. I will go to the Minister.
Thank you, Mr. Chair. Mr. Chair, this is not federal funded. This is us funded. So this comes from any -- either through any of our revenues or -- this is GNWT funded so there isn't no federal line attached to this core funding. The actuals -- like, yeah, as every year up -- this has been gone over the cost of providing services outside the territory plus the travel. And I think the travel piece has been a huge increase to that cost and the numbers of people that are actually utilizing these services. So we have, you know, on average it's -- you know, before -- before COVID, there was about, you know, 200 on average a year going out with, you know -- and then post-COVID, I think 2022-2023 to 2024-2025, it's gone from -- up to 400 people going out for addictions services. And so the cost of the provider and the cost of the travel, the cost -- this program has always provided, you know, depending on the need of the patient and how far they're travelling, you know, they also -- they require an escort sometimes because of their addiction and they need to be able to get to where they need to get to. Sometimes they need to detox and things like that. So there's many different reasons why this has gone up, but those are the main ones. And that's why it's under review as part of the health sustainability unit because it's one of the biggest costs. Like, when we average out where we're spending -- overspending for the amount of dollar allocated and the amount of overages, the percentages is flagged. So that's why it's one of the first things that's going to be looked at with recommendations on where we need to be -- how we need to be funding this.
And I will be honest, like one of the things that we have looked at is we've -- you know, there has been conversations about providing services in the territory and, you know, even talking with different organizations, and we are working with an Indigenous organization right now to provide, you know, in territory services. And so that work is on going right now. It's working with our partners to be able to provide services in the NWT and what's the best way. And we know that some of the people that are going out, they are requesting to leave the territory to do these services because of the -- all of the supports that they have that are there that, you know, to be able to provide that in the territory, we struggle to retain those health -- those mental health workers, those counsellors, and then the O and M to have a building and all of that. So this is something that, you know, I will continue to bring back to the Council of Leaders in having these conversations as, you know -- because they believe -- some of them believe that they want to do the aftercare in the communities and we could continue to focus on this, and then there's the other 50 percent that want the in territory. And so we continue to have this challenge, but we do know it's expensive.
Okay, thank you. I will go to the Member from Yellowknife North.
Thank you, Mr. Chair. So as part of the review of the program by the healthcare system sustainability unit, are they trying to analyze the effectiveness of the program in anyway? For example, are they analyzing how many people may not manage to complete the program once they're sent down to the facility-based treatment? And I am acknowledging that everybody's journey is different and this is never sort of a linear -- like, always sort of moving forward and progressing. Anybody's struggle is always going to be two steps forward, one step back, and with lots of -- lots of detours. But are we trying to do any analysis overall of the number of people who may not be even able to complete the program or may go back over and over and over again just to get a sense of -- you know, when we do send people for treatment, you know, what kinds of outcomes we're generally seeing in the territory? Thank you, Mr. Chair.
Thank you. I will go to the Minister.
Thank you, Mr. Chair. Mr. Chair, we keep track of patients that are referred. We keep track of patients that are -- they cancel before they even -- they even fly out. And so those sometimes cost -- there's costs related to that because we have to pay for, you know, the flights and accommodations that were prebooked. There's -- we keep track of the early discharge and self-discharge clients. We keep track of the completions. And we also keep track of people that are repeating treatment. And so that is all -- I believe that's all, you know, part of the work that they're analyzing as part of this program because I believe that the -- we know that we do need the service. And if this is what it's costing, you know, I guess that's -- that's the thing is what can we do -- can we do something in the Northwest Territories that's going to lessen the cost or being closer to home? And if that option comes, that's part of -- I guess, that's -- I will have to wait and see what comes from that health sustainability unit.
Okay, thank you. I will go back to the Member from Yellowknife North.
Thank you, Mr. Chair. I am glad that we are keeping those stats because that might start to give us some clues about whether we're going about this the right way overall.
I am also wondering if the Minister or if the department is doing any analysis -- my understanding is not all of the facility-based addictions treatment programs down south are really focused or oriented around trauma. There are some specific centres that focus on trauma and can even welcome, you know, families as a whole coming in and dealing with that, and others don't necessarily take a trauma lens, and so therefore some centres or treatment programs might be, you know, more appropriate for some than others. Is that part of the analysis in terms of are we ensuring that people are going to the right kinds of programs that are going to best meet their needs? Thank you, Mr. Chair.
Thank you. I will go to the Minister.
Thank you, Mr. Chair. Mr. Chair, the case workers work closely, like the -- so that every person that travels out has a case manager, and they work with the client to find the facility and the program that best meets their needs. We also have programs through child and family services that work with families that will work with a family that also, you know, finds the most appropriate program for them to work through -- you know, if it's trauma or addictions. And most of them that do travel for these programs have -- you know, they have to continue to follow up with their caseworker. However, when we talk about, you know, Indigenous programming throughout Canada, of course it's not going to be the same to our culture and our beliefs in the Northwest Territories. I mean, even within the Northwest Territories travelling from where I am from to the southern part of the territory are two different cultures, so to build one, even in the territory, it's going to be very -- you know, it may not meet every cultural need. However, we are -- like, as I mentioned, you know, we are continuing to work within the territory with a group on, you know, what can we do within the Northwest Territories for trauma because we could know that it is a need. We do have a contractor that does specifically -- that I believe that we can work with and that focuses on trauma. But the contractors that we have right now that we work with are through an RFP process we put out, and these are what we say that we need them to be able to provide and then they put their -- through the RFP process. And then we go down and review it and make sure that they providing the things that they say that we're asking to do. Thank you.
Okay, thank you. Is there any further questions? I am going to go to the Member from Monfwi.
Since we're talking about the facility-based addiction treatment, I know that Tlicho government they're doing their feasibility study regarding the treatment centre. I just wanted to ask the Minister if they are working with the Indigenous government such as Tlicho government who are doing their own studies to, you know -- to accommodate. Thank you.
Thank you. I will go to the Minister.
Thank you, Mr. Chair. Mr. Chair, I believe we work with the -- well, we do work with all of the Indigenous governments through -- with the Council of Leaders, and we have the Indigenous -- or we have the council's -- what is it -- the health working group through the Council of Leaders; however, you know, if an Indigenous -- and this is one of the areas where it's exciting because, you know, with Indigenous governments and self-governments, you know, they can work directly with Indigenous Service Canada as they have -- they have detect funding pots created for wellness, and so it's exciting, and I look forward to being able to, you know, see what comes of their program. And we most definitely will work with them how ever they want us to. Thank you, Mr. Chair.
Thank you. I will go to the Member from Monfwi.
Thank you. Thank you, Mr. Chair. You know, lately -- well, I do admire and I do encourage and support, you know, our people reaching out for help to attend -- to deal with their addictions, you know, it's not something easy, for many. And in the past, it was alcohol, but lately we know that it's not alcohol; it's the drugs, drugs that are coming from outside, fentanyl, crystal meth, you know, crack, crack cocaine, heroin, and even with the recent waste management -- the testing of our waste management in the Tlicho region, it all confirms all the stuff that we've been -- we've been hearing about. So I really do -- you know, like -- I do admire the young people that are reaching out for help, but I just want -- you know, living in the small communities, we all know of someone, we all know of family members, even myself, you know, of -- that have issue, you know, and that are -- we know a lot of young people are struggling with addictions, and we know of someone that is a drug dealers. So even -- you know, I don't want to identify -- you know, I am not going to say names, but that's not -- you know, it's -- but we all know who is selling drugs in our small communities. I even have a neighbour, you know, selling drugs out of their place. So a lot of these vulnerable people are being used. We know that they are. And daily, you know, like, even for the weekend that I was home, I see young people walking over there, young people, teenagers. So when they walk out when I am outside, some of them, I know -- they know that, you know -- they don't look at you. They just walk facing the other way because they know that I am going to question them, or they go the other way. They try to avoid you. And this is happening in many of the small communities, so. And I know that the law, if we call the RCMP, they want -- you know, there's all kinds of questions that they ask. So I just wanted to ask the Minister if -- if the department is working with the Department of Justice in regards to -- with regards to dealing with the drug dealers. You know, are they working with them to make it more easier for people who are complaining? Because even this past weekend, somebody did complain and I said well, call the police and they said they're asking a hundred questions, you know, and by the time they answer all the questions, like, it's too late. Things like that. So I just wanted to know if -- because I know -- and I really do appreciate my colleagues here who really address the addiction and because the majority of the people who are suffering are our young people, the Indigenous, so I really do appreciate Ms. Morgan -- I do appreciate everybody that, you know -- because it's not just us that has to do it. It's all of us. We want a healthy, you know -- we want our young people to be healthy. We need them for future. And if we don't do anything, like now we're in this crisis situation -- because in 2013 when they closed down the only health -- treatment facility, you know, they knew -- I am sure they knew all about this, that it was going to happen, what was going to happen. And just like the Minister said, you know, like, they keep track of everybody that went out and that early release and that cancelled flight or those who cancel the programs, I mean, that is really good. It's good to know. But it's -- it's just that I just -- I know health should -- and social services should not be just yours only but working with other department to see how we can fight against these addiction, what can we do to help our young people to make the system better for the people out there that wants to report. Even me saying, you know, I know -- I have a neighbours -- my neighbour, you know, they're selling drugs out of his house. I know that, you know. Things like that. It's just that it would be nice if we can -- if the system worked with us. And I am sure we can do more in that area. So I just wanted to ask the Minister if they are working with the other departments. Thank you.
Thank you. I will go to the Minister.
Thank you, Mr. Chair. Mr. Chair, I believe that, you know, when it comes to this issue, we're -- we as a Cabinet are all -- we are all working through this, and I know that my department and justice and the RCMP, they also -- they also are working together right now, you know, and I -- it's just -- yeah, it's an area that it came, you know, and I -- it's a hard place because when we have people who are afraid to report, we also have people that are, you know, are afraid to leave for treatment. We have -- you know, when we hear about people that are coming home from treatment, you know, when I -- when I hear from residents and I -- my own community, it's -- when they say, well, there's no aftercare and I say, well, what specifically do you need and many of them, you know, they do say housing because they leave from situations where they are homeless because they've been in their addiction for so long and they are coming back to a place where they don't have a home to go back to, they've got broken relationships with their families, you know, and it is a really hard place to come back. But I know that, you know, with the work that we're trying to do through the transitional housing, I know -- you know, I can't speak for the amount of things that the Minister of housing has got on her plate, but we continue -- her and I continue to have conversations as well in that area so that we are trying to work as a whole of government to tackle this issue. Thank you, Mr. Chair.
Thank you. I will go to the Member from Monfwi.
Thank you. Okay, I really do appreciate. Thank you. Because this is a sensitive topic and because it does involve majority of the client that we're talking about are young people, the Indigenous and, you know, I know a lot of them that went out for treatment. And people that are close to you, you know. And even now, there's people close to you that are leaving their community. That's going to -- you know, going out for treatment to help themselves, which is good. And coming back to the same old -- it's not going to be easy journey because we know -- just like you mentioned, trauma. There's a lot of issues that they're going to be dealing with when they're there, and sometimes, yes, maybe we might not have those trauma team so it's -- a lot of things -- they're going to go through a lot of things when they're out there. But it's helping them. In many cases, in many situation, it's helping them. We know that, you know. And so with the -- coming back to the same old -- and I know this is a capital project, but I've mentioned it before too as well, what we need in Tlicho region is a transitional housing program. Transitional housing programs, both the facility and operations budget. So I just wanted to know if -- if there's any plan in place for Tlicho region to have a transitional housing program to accommodate our young people. It doesn't matter where it is, if it's in Gameti, Wekweeti, or Whati, or Behchoko, a facility to help our young people. Thank you.
Okay, thank you. I will go to the Minister.
I will keep it short. We have the two transitional housings right now just because it's -- we've never had that program in the territory, we're just analyzing the current one that's open and operating, and then we'll be -- and that one's an NGO in Yellowknife that's non-Indigenous but it services anybody who comes back. But we also are working with an Indigenous up in Inuvik. But I will take this back too, because I know that my department works with housing and, you know, I hear the Member, and I know of the struggles that her region is having. But we also, you know, have heard from Hay River. They are, like, at an epicentre of this situation as well. And so there is many communities in our territory that are -- I would like to have one in every community, but we need to make sure that we get -- we get it right while we're rolling these out and so if we -- you know, when we have these two open and running successfully and patients are coming back and transitioning back into -- you know, supporting them back into everyday life, then we know it's a success, and then we -- you know, that's where -- that's where when we throw our money at these good things. Thank you, Mr. Chair.
All right. Thank you. Is there any further questions from Members? Seeing none, we'll continue on. Please turn to page 212.
Health and social services, out of the territory services, $99,750,000. Does the committee agree?
Agreed.
Thank you. Moving on to supplementary health benefits, beginning on 214 with information items on page 216. Are there any questions?
I will go to the Member from Frame Lake.
Thanks, Mr. Chair. First thing I wanted to ask about was the extended health benefits. I note that the cost went up from 13 to 16 last year and continues to be 16 this year. So my understanding of the original reason they brought about the HB changes was to save money. So how did we end up with the program that costs more?
All right, thank you. I will go to the Minister.
Thank you, Mr. Chair. This is actually a good news story because we usually have to put forward supps or add to the deficit for many of our medication costs previously with the funding, and we were able to increase the funding with the costs for -- drugs for rare disease agreement through the federal government that will increase the amount of money coming to pay for a lot of those costs that extended health benefits pays for those medications. Thank you.
Thank you. I will go to the Member from Frame Lake.
Okay. So if I heard the Minister correctly, she's saying that we have received more money to offset the costs of administering this program. Can the Minister -- and the Minister can confirm that for me in her answer, but I am also wondering -- I mean, the goals kind of shifted as this program came about. So have we -- have we got any stats on program implementation? I think it's been, if I am -- about a year since the policy changed at least. Does the Minister have any information for us on what's changed, who's accessing the program, what people -- benefits are like now that the program's in place. Thanks.
Okay, thank you. I will go to the Minister.
Thank you, Mr. Chair. I am currently just waiting for the finalization of the first year's analysis, so I don't have that information. I should have that within this next month. However, we do know that there are currently, as of January 15th, 3,721 individuals registered for benefits as seniors in the Northwest Territories. And we have 894 individuals registered for the 2025-2026 benefits.
Okay, thank you. I will go back to the Member from Frame Lake.
Thank you. I appreciate the numbers, but it's a little bit hard to know what to do with those out of context so it would be interesting to see -- like, is the department producing -- it sounds like the Minister's got a report coming. I guess my next question is, is that something that's going to be provided to Members or committee (audio) expand upon that question. I mean, it would be helpful to see numbers presented in context. What was -- what were numbers of uptake like and covers, like, prior to adoption of the new policy and what are uptake numbers like now and have they changed significantly, are more people accessing the program, is it the same people accessing the program. Because what I am trying to understand is if the program changes have been successful, so we'll need a fair bit of context to be able to make a determination on that. Thank you.
Okay, thank you. I will go to the Minister.
Thank you, Mr. Chair. Mr. Chair, as I mentioned, as soon as I have that report and I review it and then there's a process that we use to go through and as soon as I have briefed my colleagues on it and then I will offer a briefing to committee on that as I committed previously. Thank you, Mr. Chair.
Thank you. I will go to the Member from Frame Lake.
Thank you, Mr. Chair. I think just a piece of feedback as you prepare that report, I mean it would be very helpful for us to understand what success was supposed to look like in the beginning -- or to begin with. I -- throughout the process of developing that new policy, we got a lot of feedback, negative feedback, from residents who didn't want to see the policy changed. I can't say I heard from anybody who was excited that the policy was changing so that they would be able to access benefits. And so I am curious what we're defining as success in terms of implementation of this program. So curious to see that. I will leave that point there. But, I mean, it -- yeah, it's a funny one for me. I will take the Minister's word for it at this time that it's a good news story that we've received more money to administer the program; that is good, but it's just interesting to see the program cost increase considering what the justification was. It certainly leaves me with a hint of doubt in my mind about the big process we're going through for healthcare system sustainability if one of our small efforts to save money has resulted in a program increasing in cost.
On medical travel, I note that there is a significant increase between 2025-2026 and 2026-2027. Can the Minister help us understand what that cost increase is about?
Yes, thank you. I will go to the Minister.
Yes, thank you, Mr. Chair. Just to the comments, I also wanted to say that just from the information that I have, we do have 433 new registrants on the extended health benefits that weren't previously eligible before and so that's something that we were targeting, to try and get people that weren't eligible before. However, I will go to the question that's asked, and that is due to the air ambulance contract that was renewed. We previously had a 10-year, I believe, and it renewed, and the cost of that contract has increased significantly from when it was negotiated previously just due to the costs of doing business in the North and air travel and staffing and staffing that contract. Thank you.
Okay, thank you. I will go back to the Member from Frame Lake.
Thank you, Mr. Chair. And so just to help me understand that contract costs, so like once that ten-year contract was in place, costs were effectively fixed for ten years and so when we see an increase now, it did look like a significant increase but it could perhaps just be accounting for inflation, is that correct? Or is the Minister including supps for different costs? Does the cost escalate every year, or is it kind of only any time that we sign a new contract? Thanks.
Thank you. I will go to the Minister.
Thank you, Mr. Chair. Based on historics, that's the average that they use for medivacs and, you know, in a generation of the increases over the years. So because each air ambulance flight is a certain cost and so what they come -- how that's -- I believe it's budgeted is is that it's the average with inflation with the actual cost of doing business, and so that's what -- that's what it is. Thank you.
Okay, thank you. I will go to the Member from Frame Lake.
Thanks, Mr. Chair. Perhaps with the last minute that we have, I could just ask for a bit more clarity there. What I was asking is, you know, once we've established a new contract, is that fixed for a certain period of time where we're going to see the costs as fixed, or is it something that -- because it sounded to me like the reason the costs went up significantly is because we negotiated a new contract which hadn't been renewed in ten years. So does that ten-year contract have fixed costs, and does the new one have fixed costs? So what I am asking is is this going to increase year over year, or is the cost now fixed at about $22 million? Thank you.
Thank you. I will go to the Minister.
I will try and be more clear. We have negotiated fixed costs however it's fixed costs per flight. So if there's more air ambulance traffic, then it's going to be more. So at the end of the year, we average what -- you know, the historical information is on medivacs, the amount of medivacs, and then we budget it accordingly to that. So, yes, the contract is fixed but it's the amount of -- like, so if there's -- say, there's a hundred more medivacs next year than what we budgeted for the average, if it's a hundred more than what was the average, then it will be a little bit more and we'd have to come back and look for more money. Thank you, Mr. Chair.
Okay, thank you. I will go back to the Member from Frame Lake, if you had a follow-up.
