Yeah, thank you. Just may as well ask one last question on this. That is is there just one provider that can provide medical travel, or was this something that we went out for RFP on and this happened to be the lowest bidder? How did it work, acquiring that contract for medical travel? Thanks.
Okay, thank you. I am going to go to the Minister.
Thank you, Mr. Chair. That went out for RFP.
Okay, thank you. Is there any further questions?
I will go to the Member from Yellowknife North.
Thank you, Mr. Chair. So picking up on the same line of questions as my colleague, around the air ambulance contract, can the Minister clarify what -- how much per year did the cost of the contract increase by? Because it looks like our medical travel budget has increased by $13.3 million. So that's more than double it was previous. How much of that increase is due to the air ambulance contract specifically? Thank you, Mr. Chair.
Thank you. I will go to the Minister.
Thank you. I am going to turn it over to the ADM.
Thank you. I will go to the ADM.
Thank you, Mr. Chair. The contract increased by $13 million net. That factors in any offsets that are expected, like from billing back third parties, etcetera. So that's not the exact dollar value of the contract but it's the net impact of the contract increase. Thank you, Mr. Chair.
Okay, thank you. I will go to the Member from Yellowknife North.
Thank you, Mr. Chair. So looking at our latest annual report on medical travel, it shows that our -- the cost of emergency air travel, so just the air ambulance, has actually been decreasing over the last three years. There's been less cases, and we've had an overall decrease in cost. So I am having trouble understanding why this budget significantly more than doubles all of a sudden the cost of air ambulance in a given year. Can the Minister explain how that makes any sense. Thank you, Mr. Chair.
Thank you. I am going to go to the Minister.
Thank you, Mr. Chair. Mr. Chair, with the billing part of air ambulance, so say for instance non-insured health benefits, all of the air ambulance flights for First Nation and Inuit in the Northwest Territories that don't fall under employer benefits get billed to NIHB, and I believe that the billing for NIHB is -- has what's -- there's more going through to NIHB to cover those costs now. I am not sure if it wasn't being billed before. Yeah, my understanding is there was -- some of it that wasn't being billed. And so that -- government was paying for those costs. And so with the -- I believe the special allotment and there's all the extra core funding that -- the extra supplementary funding that NIHB has been giving to us, we've been able to bill back a lot of that fund directly back to NIHB whereas before it wasn't being covered. It was $200 each way.
Okay, thank you. I will go to the Member from Yellowknife North.
I know that there's a lot of numbers here that we're dealing with, but what I am looking at in terms of trends is that we -- over the last three years, we've had less and less actual air ambulance flights, not a huge amount less but a slight -- slight decrease, and so we've just negotiated this new contract, and so I would assume, unless I am wrong, that we're not imagining this year we're going to double the amount of air ambulance flights all of a sudden, that there won't be a need for that because the evidence has been showing the trend over the last few years has been going down, so if we have roughly the same or slightly less amount of air ambulance flights that we're going to need, are you saying that this year we're going to be paying more than twice the same amount for the same services we got last year? Can -- is that -- does that represent what's happening here? Thank you, Mr. Chair.
Thank you. I will go to the Minister.
Thank you, Mr. Chair. It's very -- I guess it's hard to explain it. It's very confusing because it's -- a lot of this is flow through, billed back. And I know that the last couple of years we have had increased funding to be able to bill back a lot of -- to allocate funding to this through NIHB to pay for the full costs. That's what we've been negotiating. We had a two-year negotiate agreement with NIHB. That's why it looks like it's gone down over the last couple of years because we hadn't had to budget as much to this. However, we still have a portion that we have pay for those that don't have insurances, for those that live in the Northwest Territories, to be able to access this air ambulance, and so that's why there's still a portion of that previous air ambulance contract. But then with the new air ambulance contract, there was new things added in that. I can turn it over to the ADM to be able to explain that a little bit.
Thank you. I will go to the ADM.
Thank you, Mr. Chair. So the old contract 10 years ago, 12 years ago maybe now, the pricing that was done was -- we actually had the benefit of a larger portion of the contract being a fixed cost, which saved us a little bit over the ten-year period and mitigated some of the inflation and volume that actually occurred. So we were very much expecting this new contract when we went out to RFP to come back significantly higher, and it did, because there was a catch-up for all the inflation that had happened over that ten-year period as well as the increase in volume over that ten-year period. Over the last couple years, the volume, I think, is maybe going down a little bit. And as the Minister said, our net costs are being offset by the increased revenue that we're getting from Indigenous Services Canada to support medical travel for Indigenous residents.
The new contract, while it's providing largely the same service, does have some benefits built into it. So previously we only had one aircraft that was capable of transporting bariatric parents. So the new contract has more than one aircraft that can do that so now we can be moving aircrafts, like, at the same time. We don't have to keep one aircraft just in case we get a bariatric patient. So that was a significant increase because it was less down time for the flight, the ambulance overall -- the aircraft overall. In addition, there was some changes done to the operational support staff to have three critical care teams working 12 hours a day instead of two critical care teams working 12 hours a day. So, again, it supported that ongoing nature of less down time for the flights. And that did come with some additional costs for the contract as well but it was for a better service that we were getting. So I will stop there. Thank you, Mr. Chair.
Okay, thank you. I will go back to the Member from Yellowknife North.
Thank you, Mr. Chair. Can the Minister tell us how competitive the bidding process was? I know she said it went out to RFP. Can she tell us how competitive it actually was or whether we were forced to be sort of a taker of what someone was willing to give us. Thank you, Mr. Chair.
Thank you. I will go to the Minister.
Yes, I believe that there was more -- there was other bids that came in. As far as that information, I don't have any other information on it.
Okay, thank you. I will go back to the Member from Yellowknife North.
Thank you, Mr. Chair. Just with the last minute I have here, I wanted to get in a question with -- asking for a bit more detail on -- so the new medical travel case managers that are being put in place, which I think is a really positive step to better manage medical travel, it seems that the Minister has been saying that these three new case managers will be overseeing all medical travel patient cases but that seems pretty overwhelming, so I assume they'll have to, like, have some criteria for which ones they zero on this or focus on reviewing. Are they going to be focusing on just a specific subset or some -- just some medical travel cases to try to flag whether or not, you know, it can be better coordinated or combined, or are they -- are we really expecting these three new case managers to be looking over and reviewing every single medical travel request that comes in? Thank you, Mr. Chair.
Thank you. I will go to the Minister.
Thank you, Mr. Chair. Mr. Chair, their role is to do case reviews, and so we have -- you know, we could probably -- they could probably have the first year just flagged with all of the concerns brought forward to my office that they need to start flagging on these issues, and they will continue to do that and that will -- that is what will help implement the changes that are operationally happening, you know, right at the frontline. So if there's certain things that they need to give direction on and things like that to the frontline staff that are -- this is their -- this will be their role so when we look at they need to be -- before actioning something, you know, this is the process that you need to follow. And I think that's what they'll be doing, is they'll be finding the areas where we have patients where they're -- you know, we've heard many times patients travelling multiple times in a couple -- in a month, you know, and trying to figure out the process of how do we streamline that. That's the kind of case management/clinical management that they will do within the medical travel office.
Okay, thank you. Is there any further questions?
I will go to the Member from Monfwi.
Thank you. Thank you, Mr. Chair. Okay, I know we -- you know, health department -- health is very important. That's one of the most important departments especially when it's -- especially for the Indigenous as well. I mean, for the Indigenous, because it deals with everything, and so -- and I know that the Minister -- Ministers, they all work with the Council of Leaders and who are all Indigenous, Indigenous leaders. I just want to ask, this is regarding the transparency and accountability. Is there any -- we don't know what's going on with the -- you know, I mean, we have a rep over there but then -- it would be nice to see a report, some kind of a report on what's going on or, you know, what are you working with or how -- not how but what -- we just need a report where -- on the topic, what is it, you know, because each region -- like you said before too, each region is different, and we -- all our wants and needs are different in -- especially in the small communities in the regions outside of larger regional centre. So it would be nice -- did the -- I just wanted to ask the Minister have they done any report, is there a report available for us to see so that way next time that we are prepared of -- we know of what the working relationship, the working group, from the Indigenous to GNWT, if there -- if there is a report existing, it would really help us a lot too. So it's just for -- it's just a question -- it's just a comment. I am not too sure if they've done that already or it's just all, you know, talking, that's all they do. I am not too sure. But if there's some kind of a report, it would be nice to share with us. Thank you.
Thank you. I am going to go to the Minister.
Thank you, Mr. Chair. Mr. Chair, if the Member is referring to the Council of Leaders, I know that there's usually a communique from the discussions that happen. And I can bring this back to my -- to my colleagues -- sorry, it's been a long day -- bring back to Cabinet, and then I can see if there's a report that's generated or an update for Members on the discussions that happen. I do know that we do have the AOC chair that attends, and I am not sure how that briefing or information is passed along, but I will bring this back to my Cabinet colleagues. Thank you.
Okay, thank you. I will go back to the Member from Monfwi.
Thank you. Thank you, Minister. Yes, it would be nice to see some kind of a report just so that we are aware of what's going on between Council of Leaders and the Ministers and -- but, I mean, specifically I am more interested in the department of health and education so I guess that's -- that really -- it helps our regions and our community because most of the employment that we have in our small communities is health and social services and education. Thank you.
Okay, thank you. I will take that as a comment. I will continue on. Is there any further questions? Seeing none, no further -- sorry, go to the Member from Great Slave.
Thank you, Mr. Chair. Apologies for not putting my hand up higher.
Continuing on the line of questioning that my colleague from Yellowknife North had, is there a substantiation that the health Minister can give around the increase of $13 million on the medical travel? Like, something that she could table in the House about the breakdown of why exactly it is so much more than it was previously? Because I don't feel like we're getting a clear understanding of why it's increased that much. Thank you, Mr. Chair.
Okay, thank you. I will go to the Minister.
I will take that back, and I am not -- because it's a procured service, I am not -- I know that there's things that are publicly available, but I will take back to see what I can publicly share with -- and I can also take back -- and get my staff to be able to kind of say what the difference over the last little bit -- from the last contract to this contract and why the changes, what's incurring those changes in the costs, for Members, if that helps.
Okay, thank you. I will go back to the Member from Great Slave.
Thank you, Mr. Chair. And, yeah, if the Minister's staff has further pieces to add at this point, I think that would be helpful. I'd definitely like to know what they can't explain here on the floor today and have any additional information shared in the future. Thank you, Mr. Chair.
I will just take that as a comment, then.
(audio).
Okay, I will go to the Minister.
At this time, the -- as I mentioned, the new ten-year agreement is to respect the next ten-years and so using the inflation -- and that's why such the difference because the last contract ten years ago, there wasn't as many inflationary, there wasn't as many -- you know, the cost of travel wasn't as high. So what we have shared, I -- as I mentioned, I will take this back and share publicly with what I can share publicly. And I will see if I can do a different -- a comparison of the two -- the two, the previous and this contract, to show why the cost difference. Thank you.
Okay, thank you. I will go to the Member from Great Slave.
Thank you, Mr. Chair. That's all for now.
Okay, thank you. Is there any further questions? Okay, please turn to page 215.
Health and social services, supplementary health benefits, $41,097,000. Does committee agree? Okay, thank you.
Committee, I am going to turn to the Member from Inuvik Boot Lake.
Finalize?
Thank you. There are additional information items on page 217 to 221. Are there any questions? Okay, seeing none, I am going to go to the Member from Inuvik Boot Lake.
I will go to the Member from Mackenzie Delta, my apologies.
Thank you, Mr. Chair. On your active positions, there's been an increase in positions for the Beaufort Delta. Can you elaborate on that; where are these positions and what positions are they? Thank you, Mr. Chair.
Thank you. I am going to go to the Minister. Or the deputy minister.
