Thank you very much, Mr. Chair.
I'd like to thank you and the committee on indigenous and northern affairs for the opportunity to contribute to your study of the accessibility and administration of the non-insured health benefits program.
I am on the line from Yellowknife, capital of the Northwest Territories and traditional home of the Yellowknives Dene First Nation and the Métis.
As Mr. Main explained and as is similar here, the GNWT administers portions of the NIHB program on behalf of the federal government, with a service agreement worth $16 million a year. Our current agreement with the federal government expires on March 31 of next year, so the timing of your discussion is important. You have an opportunity to recommend changes that will strengthen the NIHB program.
First, I have a little background on the NWT. We have a population of 44,000 residents living in 33 communities dispersed across one million square kilometres. A total of 44% of the population is eligible for benefits under NIHB and an additional 6% receive Métis health benefits. Métis health benefits are aligned with NIHB and are paid for by the territorial government at a cost of $3 million a year.
Because of the number of small communities and a lack of access to year-round roads, access to benefits under NIHB, particularly medical travel, are critical to good health outcomes. The GNWT offers benefit programs pegged to the same level of coverage provided under the federal NIHB program to eligible residents, including the Métis and non-indigenous populations.
The GNWT recognizes the importance of providing a safety net to residents to reduce financial barriers to access health benefits not covered by the NWT health care plan. The GNWT's medical travel policy, for example, mirrors NIHB and offers the same benefits.
The federal government has been an important partner in supporting the integrated service delivery model by providing funding to improve health services in areas of home care, mental health and addictions, system innovation and, most recently, of course, to assist in the response to COVID-19.
Now I would like to explain some aspects of the GNWT role in the federal NIHB program. The GNWT administers some parts of the NIHB program, as I said, on behalf of the federal government, including medical travel, dentist trips to communities, applications for medical supplies and equipment, arranging for the vision care team to visit communities for their NIHB clients and pharmaceutical coverage.
Our role as an administrator puts us in a position where we implement the federal program and the public holds us responsible for it. In fact, we are the filling in the sandwich. This is not our program; however, in our role as administrator, we do receive feedback from NIHB clients on issues and concerns with the program, which we share with the federal government for their awareness. Based on our experience in administering benefits, we know that not all residents who self-identify as indigenous have access to non-insured health benefits because their Indian Act status is in dispute.
Medical travel, as I mentioned, is a very important part of the benefits of the NIHB program in the NWT, given how remote most communities are. It's also the area in which we receive the most complaints. The complaints address who is eligible for a non-medical escort and the timeliness of approval for medical travel and for escorts. As Mr. Main outlined, the GNWT incurs additional costs associated with medical travel that are not recognized or remunerated by Canada. For example, 75% of the cost for non-medical escorts for NIHB clients is based on its service criteria and currently costs the GNWT $3 million a year.
To support opportunities to provide feedback on the NIHB program, GNWT works closely with ISC to facilitate trilateral engagement sessions with indigenous governments, and we expect one of these sessions to be held later in the year.
Our vision for the future of NIHB administration comes from the TRC calls to action, in particular action 20, which states in part “we call upon the federal government to recognize, respect, and address the distinct health needs of the Métis, Inuit, and off-reserve Aboriginal peoples”.
One way to implement this action and advance reconciliation is to explore opportunities for greater direct involvement and leadership for NIHB in the NWT by indigenous government organizations.
We are happy to work in partnership with the federal government and the IGOs. I hope this information is helpful, and I look forward to answering any questions you may have.