Manitoba Hansard — 13 May 2022 (Sitting 48C, 42nd Legislature, 4th Session)

42-4-48c

Manitoba — Debates (Hansard)

Fourth Session – Forty-Second Legislature of the Legislative Assembly of Manitoba DEBATES and PROCEEDINGS Official Report (Hansard) Published under the authority of The Honourable Myrna Driedger Speaker Vol. LXXVI No. 48C - 10 a.m., Friday, May 13, 2022 ISSN 0542-5492

MANITOBA LEGISLATIVE ASSEMBLY Forty-Second Legislature Member Constituency Political Affiliation ALTOMARE, Nello Transcona NDP ASAGWARA, Uzoma Union Station NDP BRAR, Diljeet Burrows NDP BUSHIE, Ian Keewatinook NDP CLARKE, Eileen, Hon. Agassiz PC COX, Cathy Kildonan-River East PC CULLEN, Cliff, Hon. Spruce Woods PC DRIEDGER, Myrna, Hon. Roblin PC EICHLER, Ralph Lakeside PC EWASKO, Wayne, Hon. Lac du Bonnet PC FIELDING, Scott, Hon. Kirkfield Park PC FONTAINE, Nahanni St. Johns NDP FRIESEN, Cameron, Hon. Morden-Winkler PC GERRARD, Jon, Hon. River Heights Lib. GOERTZEN, Kelvin, Hon. Steinbach PC GORDON, Audrey, Hon.

Southdale PC GUENTER, Josh Borderland PC GUILLEMARD, Sarah, Hon. Fort Richmond PC HELWER, Reg, Hon. Brandon West PC ISLEIFSON, Len Brandon East PC JOHNSON, Derek, Hon. Interlake-Gimli PC JOHNSTON, Scott, Hon. Assiniboia PC KHAN, Obby Fort Whyte PC KINEW, Wab Fort Rouge NDP LAGASSÉ, Bob Dawson Trail PC LAGIMODIERE, Alan, Hon. Selkirk PC LAMONT, Dougald St. Boniface Lib. LAMOUREUX, Cindy Tyndall Park Lib.

LATHLIN, Amanda The Pas-Kameesak NDP LINDSEY, Tom Flin Flon NDP MALOWAY, Jim Elmwood NDP MARCELINO, Malaya Notre Dame NDP MARTIN, Shannon McPhillips PC MICHALESKI, Brad Dauphin PC MICKLEFIELD, Andrew Rossmere PC MORLEY-LECOMTE, Janice Seine River PC MOSES, Jamie St. Vital NDP NAYLOR, Lisa Wolseley NDP NESBITT, Greg Riding Mountain PC PEDERSEN, Blaine Midland PC PIWNIUK, Doyle, Hon. Turtle Mountain PC REYES, Jon, Hon. Waverley PC SALA, Adrien St. James NDP SANDHU, Mintu The Maples NDP SCHULER, Ron Springfield-Ritchot PC SMITH, Andrew, Hon.

Lagimodière PC SMITH, Bernadette Point Douglas NDP SMOOK, Dennis La Vérendrye PC SQUIRES, Rochelle, Hon. Riel PC STEFANSON, Heather, Hon. Tuxedo PC TEITSMA, James Radisson PC WASYLIW, Mark Fort Garry NDP WHARTON, Jeff, Hon. Red River North PC WIEBE, Matt Concordia NDP WISHART, Ian Portage la Prairie PC WOWCHUK, Rick Swan River PC Vacant Thompson

1969 LEGISLATIVE ASSEMBLY OF MANITOBA Friday, May 13, 2022 The House met at 10 a.m. ORDERS OF THE DAY (Continued) GOVERNMENT BUSINESS (Continued) COMMITTEE OF SUPPLY (Concurrent Sections) ROOM 254 HEALTH Mr. Chairperson (Dennis Smook): Will the Com- mittee of Supply please come to order. Before we begin, I have a leave request for this

section of the Committee of Supply. Our long- stand- ing practice is for the opposition to sit at the commit- tee table to the right hand side of the Chairperson. Because the minister is participating virtually this morning, I am asking if there is leave for the–leave of the committee to waive this practice. This would make it much easier for the members of the opposi tion to see the screens that are situated in the room. Is–agreed? [Agreed] The

section of –this

section of the Committee of Supply will now resume consid eration of the Estimates for the Department of Health. Questioning for this department will proceed in a global manner. The floor is now open for questions. MLA Uzoma Asagwara (Union Station): I believe the–or, last time we were here in com mittee–I'm good? [interjection] Okay. The minister was actually answering a question that I had asked regarding the renovations at St. Boniface emergency roo m. I'd asked spe cifically when that project will be complete and what is the budgeted cost.

So I'm going to hand it over to the minister, as she was in the middle of providing her response. Hon. Audrey Gordon (Minister of Health): I thank the member for Union Station for bringing forward the question about the St. Boniface Hospital emer - gency department expansion. And construction on the expansion and modern- ization of the St. Boniface Hospital emer gency de - partment has officially started, following strategic design, planning. Community and stakeholder consul- tations and preliminary demolition work did see changes at the new emergency depart ment.

State-of-the-art design will reduce wait times and the length of stay in the emergency de partment, improve patient and staff experiences and maximize func- tionality and flexibility. It will have expanded space for increased numbers of patients. I am pleased to share that the project is very much on track to be completed by 2025. MLA Asagwara: I thank the minister for that response. Can she indicate when in 2025? What month? Is there a month and a date in 2025 that it's projected to be completed, and what is the budgeted cost? She didn't provide that response in her last answer. Thank you. Mr.

Chairperson: The honour able Minister of Health. Could the minister turn her mic on. Ms. Gordon: My apologies for missing that very im- portant information. The amount of–budgeted for that project is $141 million. And in terms of where it 's at, I have a recent re - port from the Winnipeg Regional Health Author ity. Decanting and renovations in phase 1–overall work progress is 91 per cent completed. So, that 's the pharmacy moving from D block into new space has started. And abatement and demolition of D block– overall work progress is 50 per cent.

So, abatement is complete in the crawl space and on the second floor; 95 per cent complete on the main floor. And demoli - tion of D block, again, was scheduled to start in April and to be completed this month. New construction under phase 2–so, their tender- ing package for site works, foundation and structure, the bid award is complete and sub- trade agreement has been finalized. Tender package on No. 3, which is mechanical and electrical–the bid award is complete and sub-trade agreements have been finalized.

1970 LEGISLATIVE ASSEMBLY OF MANITOBA May 13, 2022 And phase 3 is renovations. So construction work has not been initiated yet by PCL, but I'm soon to get a report. So what I am seeing is a lot of green checkmarks that say everything is on track. MLA Asagwara: Can the minister clarify: on track for what date of completion? She provided the year; she did not provide a month and date, so if the minister can provide that clarity, that'd be great. Thank you. Ms. Gordon: So, renovation started June 10th of '21, so actually, work had already started last year.

And as I shared earlier, phase 1(b), which is decant work and relocations, is 91 per cent completed as of today 's date. Phase 2(a), pre -construction, is 95 per cent completed as of today. Phase 1(c), demo- lition of D block, is 50 per cent completed and they estimate that by May 13th, again, D block should be– have sub stantial completion. And by April 21st of 2025, the new construction–the phase 2(b), new construction, should have substan tial completion by April 21, 2025. MLA Asagwara: Well, I appreciate that the minister has repeated some of the same infor mation over and over.

I did grasp it the first time she provided some of that information in regards to the phases and I can ap- preciate that she 's provided a bit more clarity on phase 2. * (10:10) But what I 'm looking for –for the third time –is when this project in its entirety will be completed and the projected date for that. She has provided 2025; now she's saying that phase 2 should be substantially completed by April 21st of 2025, but she has not provided when, in total, the project should be complete. So can the minister just, you know, provide clarity on that one specific point?

When will the project, in full, be completed? What is the projected date–month, day? When are they hoping to be there celebrating, you know, probably as, you know, members of the com munity coming and being there celebrating the expansion? I 'm sure she plans, hopefully, to be down there in some capacity in 2025, if that 's in fact the year that she' s saying the total project will be done. But what month are they pro - jecting in 2025 the entire project will be completed? And if she can provide clarity as to whether or not the budgeted cost has increased fr om the original budgeted cost, that'd be great as well.

Thank you. Ms. Gordon: Similar to the member for Union Station (MLA Asagwara), I'm not always well-versed on how construction works and when is some thing demolished and when is–when do we start to build. So, substantial completion, as I mentioned before, is April 21st, 2025. We begin to start operational moves into the space in–after all the testing has been completed–around August of 2025, and we're aiming for a goal line date of September 18th, 2025. MLA Asagwara: I thank the minister for that re - sponse. It's great to have clarity. I 'm glad we finally got there on this question.

I would ask that the minister provide a response to the other question that I also asked in regards to the budgeted cost for the emergency room in St. Boniface. Has it increased, and if so, why? Ms. Gordon: I'll reiterate the response I gave earlier. The budgeted cost for the St. Boniface Hospital emer- gency department expansion is $141 million. MLA Asagwara: Has that number –that budgeted number–increased from a previous amount, and if so, why? Ms. Gordon: I thank the member for Union Station for the question.

When this project was first announced in the summer of 2019, the cost was –allocated was $90 million, and there has been an increase, and our government was pleased to support the continuation of this expansion and renovation and work of one of Manitoba's key hospitals. The increases are due to COVID cost increases. We're seeing that across many sectors , the supply chain as well. And so there were several challenges, supply chain challenges, that increased the cost of materials and that is–and supplies and equipment that will go into this new expanded space. That is the reason for the increase.

MLA Asa gwara: I thank the minister for that response. I'd like to ask some questions around patient transfers. We know that several hundred people across the province have been transferred away from their home region. We also know that at one point, very

May 13, 2022 LEGISLATIVE ASSEMBLY OF MANITOBA 1971 recently–probably still ongoing, from what I 'm hear- ing–that there were many folks who have been unable to return home. In January, the minister announced hardship supports for people to be able to visit those –their friends, their loved ones who have been transferred. Can the minister provide an update on the current situation with transfers? Are they paused or are they ongoing? Ms.

Gordon: Like myself, the member for Union Station (MLA Asagwara) also worked in the health system for quite some time, and so I know that they are familiar with transfers and that people in our pro- vince cross regional boundaries every single day for care, and that is due, primarily, to our geography and how people are distributed, where they live across the province. People are coming from the North into Winnipeg through our northern patient transport program. They are being transferred for various therapies and various treatments every day.

The decisions on those transfers are being made by leadership in the health system and by c linicians, certainly not being made here in the Legislative Building by political officials. One of the reasons we decided to move forward with the clinical pre ventative services plan was for that very reason: to be able to provide services to Manitobans closer to home. And we are planning provincially but delivering locally.

I am advised by the health-care system that makes these interregional or within -region transfers that, to date, 340 patients have been moved as part of their protocol, as of–this is as of today; none were moved yesterday. They tell me that stable patients are being transferred to different sites for care following assessment by a clinical team. * (10:20) So, I want to em phasize, again, these decisions are being made in the health system. So, that is the number that I 'm aware of.

And again, they continue to tell me that people are crossing regional boundaries every day for care and they are making those decisions, Mr. Chairperson. Thank you. MLA Asagwara: I thank the minis ter for that response. You know, I would–I 've had a lot of con versa- tions with families who've had loved ones transferred abruptly, with no notice, to other health-care facilities, residences. I 've had con versations with clinicians, with folks working on the front lines of the health-care system as part of multi -disciplinary teams.

And I would just flag for the minister that this ongoing narrative that she is taking on–her and her colleagues– in regards to this being just clinical decisions and it 's on them and has nothing to do with political decision making–is one that does not sit well with families and certainly does not sit well with health -care providers and clinicians. They fully understand and are aware that it 's the decisions made by this min ister and her gov ernment that have resulted in people–hundreds of Manitobans– being transferred away from their home communities and care facilities.

It's been incredibly disruptive and harmful for folks and their families. It 's created a lot of distr ess and it 's impacted the ability of folks to recover in places where they have the support of their loved ones right nearby or right beside them.

And so, this narrative that I understand is likely a talking point that they want to continue to push to shirk accountability for the conditions that she and her government have cr eated that have resulted in 340 people being transferred away from their commu- nities to date, I would encourage her to stop that because it is quite harmful, it 's disingenuous and it 's not the approach, in terms of being accountable, that I think a lot of Manitobans have made clear they want from her and her government. So, I just wanted–I wanted to put those words on the record because it is important. This is significant.

It is not for any of us to minimize just how tough this reality is for the families who are navigating their loved ones–some of which have dementia, some of which, when they're being transferred, are in credibly distressed because they don't know what's going on or why. They think somehow it 's their fault. They 're away from what they know and understand and it impacts their well-being overall. And so, I just wanted to make sure that the minister was aware. Maybe she hasn 't heard those things directly from clinicians or family members, so I'm sharing that on their behalf because I've heard that frequently.

And her narrative around this is not conducive to folks at all –seeing what this gov ern- ment's decision making has done to our health- care system–feeling any more at ease with the ongoing– she's just indicated the transfers are not paused.

1972 LEGISLATIVE ASSEMBLY OF MANITOBA May 13, 2022 The minister has made clear that these transfers are still happening. So I 'm wondering if the minister can provide some clarity on the hardship supports that I mentioned earlier. She announced this again in January, for those visiting those who've been transferred. How much of–how much was budgeted for those hardship supports, and can she provide an update on how much of those dollars has actually been spent? Mr. Chairperson: I'd like to ask the minister if she could adjust her camera a little bit because about –or adjust it–yes, that would be perfect.

The honourable Minister of Health (Ms. Gordon), thank you. Ms. Gordon: Again, the member for Union Station (MLA Asagwara) as well as myself, we both worked in the health system, and I know for the over 12 years that I worked in the health system, transfers were occurring–and that was before even our gov ernment formed office. Mr. Chairperson, the patient trans fer protocol within the province of Manitoba, if I could update the member for Union Station, has been in place for decades prior to COVID-19 and prior to our gov ern- ment taking office.

And it 's im portant to remember that, once again, transfers are clinical decisions made by physicians and they take many factors into account. And this allows clinicians to ensure patients who need a higher level of care have access to it. We know how difficult this can be for families. That is why our gov ernment moved to develop the hardship supports for families. And I just want to put on the record that I 'm told by our health system that, this month, five interregional transfers have occurred– only five this month.

And, again, those are decisions that are being made in the health system level, not by our government. And I want to also share that we have a Northern Patient–transfer–Transportation Program that was established in 1972. And in 2015, under the previous government, 19,985 trips were made by people from the North into Winnipeg and other areas being transferred for care. So nearly 20,000 patients a year rely on this program. They 're being transferred. They're being moved, Mr.

Chairperson, and that's why our gov ernment invested the largest amount in Manitoba's history of $812 million this year to improve health care in rural and northern Manitoba, to allow for the creation of a northern intermediary health-care hub to ensure patients and Manitobans can receive care close to home. So this is not new. This is not related to a govern- ment. Patient transfers and interregional transfers have been done for decades. Mr. Chairperson, to answer the member 's ques - tion about hardship supports, the poli cy and forms went live February 22nd, 2022.

The last I checked, Shared Health advised us that a small number of individuals had requested supports. We 're asking for the updated numbers. The–I think in March there were only five requests for reimbursements. We do not have a budget for this program because we implemented this program in the midst of a fiscal year, so regional health author ities were asked to cover the reimbursement of individuals that came forward. Again, the program will allow for up to eight visits per month by a designated support person. * (10:30) Meals were available.

Meal vouchers are pro - vided for designated support persons to allow them to dine with the client if meal service was not available on site. Assistance was provided to a maximum of $8 for breakfast, $10 for lunch, $15 for dinner; transpor- tation: return bus fare or gas expenses; and ac com- modation up to a maximum of $70 per night plus taxes. And I also wanted to add some factual infor ma- tion about transfers, and when patients and families are told. So all hospital and health centres provide a letter to patients and their families upon admission, Mr.

Chairperson, to hospital, to detail the possi bility they may be transferred to another site. So it 's factually incorrect that patients and families are not being told. A follow -up conver sation is typically led by a care team member, which occurs between the patient and their family member or representative to identify suitable candidates for transfers and additional written communication is provided. That is the fact.

And I just want to ensure that we 're not, for lack of a better term, throwing out –the health system and our leaders under the bus by saying that they 're not providing notice of transfers, because that is not correct and, again, we appreciate all that they do– Mr. Chairperson: The honour able minister 's time has expired.

May 13, 2022 LEGISLATIVE ASSEMBLY OF MANITOBA 1973 MLA Asagwara: I thank the minister for provi ding that information. I can certainly see why folks–some folks–maybe wouldn't be able to access this op portunity to access the hardship supports, given that the resources pro- vided are actually just based on–you know, even that the $70 that you 're talking about to contribute to a hotel stay is markedly insufficient for many folks who wouldn't be able to maybe come up with the other half of that–what it may cost to rent a hotel for one day or one evening.

So, certainly, I can see the barriers that would still exist for many people to be able to visit their loved ones. Even the per diem amounts, I think, for many folks would be insufficient. Can the minister provide clarity on–it's five folks? Only five people, up until March, have actually accessed the support? What does that look like in real dollars? So how much money was actually spent, and what was the average amount of support provided? Ms. Gordon: I thank the member for Union Station (MLA Asagwara) for the question.

Because this reimbursement program is being applied across the province in very –in various facilities, I will have to take it under advisement. We'll have to pull that infor mation from each facility and provide a response at a later date. I do want to speak to the member 's point of the $70. I do know that regions have some discretion to look at the cost and the claims that come forward on a case-by-case basis and to possibly go beyond the amount that is esta blished, in extreme cases. So, they're certainly not bound by the parameters that have been set in the initial formation of this program.

And so, we will have to come back–I 'll have to come back with an u pdate on the hardship supports and financial assistance for patient transfers. Thank you. MLA Asagwara: I thank the minister for taking that under advisement. And I apologize, I don't think that I interpreted the information you provided, maybe, for what it actually was. So, I'm just going to ask for some clarity. The minister stated that there had been five requests. Now, can she identify if that was for March of 2022, for that month, or were those five requests since the announcement was made in January? Just so that I'm clear on that point.

Ms. Gordon: That report came to me back in March and they didn't specify whether it was for that specific month or since the program started. So again, I'll take it under advisement and I will come back with a report to the member. I also want to add, in terms of my earlier com - ments about patient transfers, that we have a radiation oncology program. And when Manitoba was not achieving timely care for radiation therapy for cancer, patients were referre d for out -of-province radiation therapy to cancer centres in Grand Forks and Thunder Bay. So, even outside of our province, under the previous government.

In fact, over the period of 1999 to the time when we took office, 213 patients were referred to Gra nd Forks. And during the period of twenty–2001 to 2003, 13 patients were referred to Thunder Bay. We have CAR T-cell therapy that's provided on a case-by-base–case basis by Mayo Clinic, and that 's been happening for years. So, the member needs to be aware that care is provided not just interregionally, but even outside of the province. And that was happening even under the NDP administration. So, this is not new, Mr.

Chairperson, and our gov- ernment took a very proactive step to support families and patients by esta blishing a hardship support and financial assistance program. That program continues to remain open to individuals who feel they would like to take advantage of that program. And we will provide a further update on its –on how much of tha t program has been used to date. Thank you.

MLA Asagwara: I think the minister was sort of alluding to the challenges around the surgical and diagnostic backlog and the Manitobans who are unable to access what they would be able to typically access here in Manitoba, and therefore, being forced to access those services in other jurisdictions. It's interesting.

It reminds me of that period of time I think we all would rather forget, when the former premier, Brian Pallister, actually stated that he would happily send educators, burnt -out and tired educators who were going above and beyond for Manitobans to provide the best education and care they could to students, that they would have to go to America to get vaccines. It was such an interesting and challenging time.

1974 LEGISLATIVE ASSEMBLY OF MANITOBA May 13, 2022 But anyhow, I 'd like to ask questions about the dashboard, actually. On the gov ernment's Info Manitoba website, the province has put up what it calls the Prov incial Health System Performance Dashboard. I know the minister is well aware of what that is. And over the last two years, financial targets in Health over the previous year 's budget were 1.6 per cent and 1.4 per cent. That's about 4 per cent less than the current rate of inflation. It's a big gap. It also leaves very little avail able for any volume pres - sure or wage settlement.

It also substan tially–is sub- stantially less, rather, than increases through the Canadian health transfer. * (10:40) With all of that in mind, I 'm wondering if the minister can explain why she feels 1. 4 per cent is an appropriate financial target for health spending during a pandemic. Ms. Gordon: I thank the member for Union Station (MLA Asagwara) for the question. COVID -related costs are budgeted in a different budget called the internal service adju stments, and they 're not in the percentages that the member is referencing because it's over and above our health- system budget.

So, COVID payments to service delivery organi zations and personal-care homes are, as I said, outside of the normal budget for health, and so for fiscal years 2021 and 2022, I will read into the record what has been paid out. But I do want to say that the COVID-19 response has [inaudible] in new and ad ditional costs to the service delivery organi zations and personal -care homes so that they can continue to safely provide care to Manitobans. That is why we developed the internal service adjustment budget.

Under this, the Province provides a quarterly reimbursement for expenditures related to COVID -19, and this includes staffing requirements, enhanced cleaning procedures and ad- ditional supplies and equipment in acute-care settings like hospitals and, again, as well as personal -care homes. So for '20-21 and projected for '21-22, COVID payments to service delivery organi zations in '20-21 is $176,961,683.

B roken down: for WRHA, $50,341,379; Interlake -Eastern Regional Health Authority, $7,767,194; northern regional health authority, $10,522,964; Prairie Mountain Health, $8,673,347; Southern Health, $98,144,681; Southern Health-Santé Sud, $1,512,118. Actuals for 2021 for COVID payments to personal-care homes: $37,110,266; broken down: for WRHA, $34,855,113; Interlake -Eastern Regional Health Authority, $456,763; Prairie Mountain Health, $409,049; Southern Health-Santé Sud, $1,389,341.

And, of course, projected for payments to service delivery organizations for '21-22: $351,873,000; and projected COVID payments to personal -care homes for '21-22: $25,785,365. So, again, the member can see that that is cer - tainly outside of the Ministry of Health budget and it– it's considered internal service adjustments, and we've gone further as a government.

For Budget 2022, we're proud, to date, that we have invested over $3.1 billion in pandemic supports to protect the lives and livelihoods of Manitobans: $630 million to strengthen the fight against COVID -19 and prepare for other variants and pressures on our health-care system; and $30 million to add 28 additional beds to our intensive care unit, which will bring our true ICU bed bas eline up to 100 from the 72 we have pre-pandemic. So our government in 2021 provided supports and in Budget 2022 we are continuing our supports of the health system: $7.2 billion total from the health -care budget in the 2022 budget.

This is the most significant health-care investment in the history of our province, and our gov ernment will continue to support our health system to ensure we recover and we advance– Mr. Chairperson: The minister's time has expired. MLA Asagwara: I thank the minister for that re - sponse and for breaking that down by region and, as well, for SDOs and projected for PCHs.

In the minister's annual report, on page 53, it says that the health transformation has achieved a net financial benefit of $23.7 million across the he alth system and a $60.5 million in net financial benefit since the start of the transformation. Can the minister provide more details on what makes up these purported savings? Ms. Gordon: I thank the member –the honour able member for Union Station for the question.

My staff are pulling that infor mation, but while we wait for that infor mation I do have an update on the patient transfer reimbursement dollars for the member: paid to date, $35,486; pending review, $5,465; a total of $40,951. And the various health

May 13, 2022 LEGISLATIVE ASSEMBLY OF MANITOBA 1975 authorities and health facilities have received 65 claims. * (10:50) MLA Asagwara: I thank the minister for provi ding that information when she received it during this com- mittee. That–I really do appreciate that. That provides a lot of clarity. I'm wondering if the minister would just be will- ing to take the question that I asked her, in regards to what makes up these purported savings –if she needs to take that as an under taking, that's fine with me so that we can move forward, b ut I'll leave that to the minister. Mr.

James Teitsma, Acting Chairperson, in the Chair Ms. Gordon: I do want to take this moment to put on the record some of the work that has been done in the health system by our leaders, clinicians and allied health. E veryone works together as a team. We 're celebrating Nursing Week, as well as health –allied health professionals, and so I just want to thank them for the incredible work that they're doing. But I also want to share some information on our surgeries and how they're progressing.

So, since January, in Winnipeg, 13,323 non- emergent surgeries have been completed, 3,604 emergent surgeries completed, for a total of 16,927 surgeries. This is in addition to the 11,000 surgeries procured by the task force t hrough the request for supply arrangements. Just last week, I was informed that there were 1,088 non- emergent surgeries completed and 241 emergent were completed. This is over 100 per cent of pre-pandemic levels, and in recent weeks, this has increased as high as 122 per cent.

In terms of diagnostics, since December we have completed 2,947 CT scans, we 've completed 3,538 ultrasounds, we've completed 1,240 MRIs, for a total of 7,725 scans and diagnostics. All emergent and urgent surgeries, including cardiac and cancer procedures, continue to be prior - itized. Elective and non -urgent surgeries are con - stantly being reviewed by physicians to prioritize patients who, medically, should not wait any longer for procedures to be performed. And I'm pleased to also put on the record that all staff redeployed or reassigned due to COVID have now returned to their normal duties.

They 're back to their acute-care facilities, personal-care homes, health facilities, and I hear that they are settling in very well back into their locations and we thank them, on behalf of all Manitobans, for the incred ible work that they did over the past two years. I also want to talk a little bit about the CIHI report because a lot has been said about that.

And one of the important co nclusions from the CIHI report for Manitobans to be reassured by is that more urgent procedures like hip fracture repair, radiation therapy and cancer surgery was prioritized in Manitoba during the pandemic as volumes remained stable. And Manitoba compar es favourably with other provinces in the areas of radiation therapy, hip fracture repair and coronary arterial bypass grafts. And in 2021, Manitoba's hip fracture repair wait time was shorter than the national wait time, and more patients had their hip fracture repair within benchmark compared with Canada.

So that was 89 per cent versus 85 per cent. And between 2019 and 2021, Manitoba's and national hip fracture volumes remained stable. At least 97 per cent of patients received radiation therapy within the benchmark in all provinces. Manitoba was the only province where 100 per cent of patients received their treatment within benchmark. So, some excellent news, as well, for our province between 2019 and 2021: Manitoba and national radiation therapy volume s remained stable, which is excellent news again for cancer treatment in our province.

In addition to that, in terms of cancer treatment, Manitoba's breast cancer surgery median wait decreased from 28 days to 21 days, and the lung cancer surgery median wait time decreased from 34 to 22 days. And as we all know, for an individual diagnosed with–hearing the horrible news of a cancer diagnosis, every day counts. So we are certainly pleased to see those decreases; while not as high as we'd like them to be, they are certainly progressing. Mr. Chairperson, so much more good news for Manitobans. We will continue, as a gov ernment, to work on their behalf to ensure we improve health services.

MLA Asagwara: Does the minister now have available, since that was a w hole–an entire five minutes that she used to provide that infor mation while failing to answer my question, regarding provi- ding more details on what makes up the purported savings? Mr. Chairperson in the Chair

1976 LEGISLATIVE ASSEMBLY OF MANITOBA May 13, 2022 Does the minister now have that infor mation available to her, and is she willing to provide it? * (11:00) Ms. Gordon: I'm pleased to respond to the hon our- able member for Union Station 's (MLA Asagwara) question about how we arrived at the savings. Certainly, Shared Services, at a prov incial level, was one of the mechanisms; through the Clinical and Pre- ventative Services Plan, targeted practice im prove- ments.

So, for example, blood utilization and how we utilize the scarce resources of blood dis tribution; Digital Health; new province-wide better contracts, so now you're negotiating at the provincial level; supply chain improvements, so better contract management and category spending, again purchasing provincial – at a provincial scale. And I do want to place on the record that all savings are reinvested back in the system and they are not extracted from the system. Thank you. MLA Asagwara: I thank the minister for that response. I actually just need a little bit of clarity on the patient transfer claims.

The minister had provided a bit of a breakdown there, which I do appre ciate, but I'm wondering if s he can advise as to –she said 65 claims were made in total. How many of those claims were approved? Does the minister –did the minister mean that the 65 represents, you know, 65 folks who applied and all 65 were approved, or could she just provide clarity on, if 65 claims were made, how many of those claims were approved and resulted in the amount that she broke down. And then after that I'll be asking a question about ER waits. Ms.

Gordon: I thank the honour able member for Union Station for seeking clarification. I do not believe that any have been denied of the 65, but I 'm seeking clari fication of that. Again, the total is $40,951 and it's 65 claims. I do not believe any have been denied. So, there was, in my breakdown, $5,465 in process, but that is in process of being paid. So the person had–the individuals haven 't actually received their payments as of yet, but I will clarify all of that. Thank you. MLA Asagwara: I thank the minister for that clarifi- cation. I do appreciate it.

I'm wondering if the minister can provide some clarity now on the area of emergency room wait times. So, last month it was reported, so that's–well, I guess, almost last month or –May, so we're talking about March, so actually a couple months now –Winnipeg emergency rooms saw the highest wait times that they have on record. Waits were alarming, I think, to all of us, at Winnipeg' s b usiest hospitals, including 8.7 hours at St. Boniface and a very con cerning 10.5 hours at HSC. I've been able to speak with doctors and nurses and health-care aides at all of our emergency rooms.

I've had conversations with folks at St. Boniface and HSC and the Grace over the past many weeks, and it's really challenging what folks are facing. Health- care workers are doing their absolute best and they're doing incredible work. Really, they' re doing heroic work, given the circum stances that they're in. But this is a challenge that is really over whelming folks not only providing care, but certainly incred ibly difficult for folks accessing care. We do know that folks have even left emergency rooms without being seen as a result.

How does the minister account for this large spike in wait times for emergency care? Ms. Gordon: I do want to say that our health -care workers are heroes, and that 's why we celebrate our nurses this week. That's why we're selling–celebrating our allied health -care workers. And that 's why, so many times, I have risen in the House to say thank you. And I want to put it on the record again that I thank everyone in the health system for the incredible work they've done over the past two years during a very, very difficult time–the pandemic.

And I recog nize that there are still m any chal - lenges stemming from the pandemic and that patient flow issues continue to be a concern for the health system, and a number of initiatives have been imple - mented in the recent weeks. And those initiatives have come forward from the hospital floor. So, it 's our health system leaders talking with staff in the emer - gency department, talking with leaders in those de - partments to generate ideas. And so, these ideas come from them.

The expansion of the physician-in-triage model of care at Health Sci ences Centre: this pilot program places a physician in a triage area to manage and provide care for those waiting to be seen, with a parti- cular focus on higher acuity patients. The levelling of

May 13, 2022 LEGISLATIVE ASSEMBLY OF MANITOBA 1977 transport arrivals across all sites and then improving lab turnaround time for patients requiring admission– we expect these initiatives will have some success in reducing those wait times, and further initiatives are in development. And, again, system leaders from both Shared Health and the Winnipeg Regional Healt h Authority continue to meet with staff and physicians to discuss their concerns and share ideas on how to improve patient flow and reduce wait times. We also continue to recruit and retain nursing staff at all sites.

Some of the early interventions, again, in terms of our ER wait times and program enhancements, we 're making changes to ambulance transport protocols to redirect appropriate lower acuity patients to an urgent care instead of an emergency depart ment. The pilot test for COVID-19 within the emergency department, again, for new patient arrivals –early evidence is that this is stream lining the process and allowing for quicker patient flow.

We are refining both the interregion transfer protocol and the virtual COVID outpatient program to better assist in maintaining medicine bed capacity in out biggest acute -care facilities, recruiting to fill nursing and other roles across the system. Our Community and Long Term Care teams are improving flows for patients ready for discharge so that they can move to their personal-care home faster. With improved summer and spring weather, our interregional transfers of individuals who no longer require acute care–clinicians continue to look at that. I've already talked about the physician -in-triage program.

I also want to share that $1.2 million has been committed to the Health Sciences Centre for the implementation of that physician-in-triage program. And just to be very clear on the record, that new investment will place a senior attending em ergency department physician in triage on a daily basis at Health Sciences Centre Winnipeg, alongside a triage nurse and a nursing assistant.

And this model of care ensures all higher acuity patients are triaged by a physician while waiting to be seen a nd reduces the rate of patients who leave without being seen by a physician. * (11:10) So I know that the member for Union Station (MLA Asagwara) raised that as a–today, and we are waiting for early results on a reduction in the in- dividuals that are leaving without being seen, and we expect this program to also begin very shortly with the–with an expansion to St. Boniface and Grace hospitals, and that will certainly help all Manitobans who are accessing care.

It's the first point of access to our health system. We want to ensure those wait times are reduced and that Manitobans receive care in a timely and efficient manner, and again, I thank all our health-care workers for the phenomenal job that they have been doing. MLA Asagwara: Thank the minister for her response, and I appre ciate that she provided some clarity just now on initiatives around folks leaving emergency rooms without being seen. Can the minister provide the most current infor - mation she has in terms of how many people are leaving emergency rooms without being seen?

What is the current number that they have for that? Ms. Gordon: I thank the honour able member for Union Station for the question. This infor mation was accurate as of –for last month. So, patients who left without being s een by a physician comprised 13.6 per cent of all emergency and urgent -care visitors last month. So, this would have been for April. In–so in other words, one in seven people going to urgent care or emergency were leaving without being seen. But those numbers, I want to add, was before we initiated the programs that I mentioned earlier.

The expansion of the physician -in-triage program, the levelling of transport arrivals across all sites and improving lab turnaround time for patients requiring admission. I do not have that updated information since these programs were imple mented at Health Sciences Centre emergency department, St. Boniface Hospital emergency department and Grace emergency depart- ment. I would have to take that under advisement and bring that information back. MLA Asagwara: I'm good with that being taken under advisement.

I appreciate the minister's willing- ness to do so, and I thank the minister for her provi - ding clarity around the current number of folks leaving. I'm–I know the minister, like I am and many others, are concerned about that number of folks leaving emergency rooms or urgent care and what that means for their well-being. But certainly, I know that, as the minister has indicated, that, you know, physicians, health -care aides, nurses, allied health professionals are doing their best to address these concerns and come up with

1978 LEGISLATIVE ASSEMBLY OF MANITOBA May 13, 2022 unique strategies. Certainly, the gov ernment has a significant role to play, in terms of providing adequate resources to achieve more positive outcomes, in terms of repairing relationships with health -care workers; you know, satisfying things like agree ments that health-care workers, some of which still don't have in place; recruitment and retention, retention being a really big component here.

So, you know, recognizing that there 's a lot of work that needs to be done, certainly on behalf of the government, to help support the efforts that are being made on the front lines by these health folks and leaders. Wondering if the minist er can provide some clarity around acute- care budgeting. So, the funding by this gov ernment for acute care, I 'm just going to outline what that's looked like recently. In 2017-2018, budgeted funding for acute care was $2.458 billion. In this year 's budge t '22-23, it 's just –sorry, it is $2.525 billion.

Now, over the seven-year span–sorry, six-fiscal-year span, that 's an increase of just 2.7 per cent. Given the acute-care crisis that we're seeing right now, given all of the challenges that are glaringly obvious in acute care, why is the minister providing– why is the minister and the gov ernment provi ding such limited funding to acute care? * (11:20) Ms. Gordon: I thank the honour able member for Union Station (MLA Asagwara) for the question.

Similar to what I indicated previously, COVID payments for service delivery organi zations and personal-care homes are outside of our Health budget in internal service arrangements and paid out there. So if it 's related to mental health as well, acute -care funding for mental health, it's now under the Ministry of Mental Health and Com munity Wellness. If it 's COVID, it's in the ISA budget, and if it 's related to collective agreements that fall under acute care, then it's, again, in ISA.

So just wanted to provide some clarification there so that the member is aware of how the funding is divided up and is being allocated to different areas. Thank you. MLA Asagwara: Does–I do–I thank the minister for that, providing that clarification. I do understand how those resources are distrib - uted. And I guess my question really would be, then, does the minister think that this amount of funding for acute care is adequate?

You know, also looking at the funding that 's provided for the regional health author ities, SDOs, you know, when we look at what that –what those numbers by percentage actually look like year over year, and certainly where things are at now, we are still looking at percentages that are well below the rate of inflation. And so when I look, at over six fiscal years, an increase of just 2.7 per cent, even looking at the ways in which these other resources are allocated, you know, and given the crisis in acute care, I 'm wondering if the minister thinks that the amount that's being provided here is really adequate.

Percentages, even when we look at the way that these resources are being distributed, again, and we look at these funds regionally, to me, you know, looking at the math here, it is clearly insufficient, and there's a crisis in acute care. There are challenges that we're going to see as we move forward, given the crisis in health-care staffing. There's a staffing short- age crisis, not just nursing, but we 're also looking at allied health-care professionals as well.

So with all of that in mind, is the minister saying that the percentage that we' ve seen over the last six years and where things are at for acute-care funding is adequate? Ms.

Gordon: I thank the honour able member for Union Station for giving me the oppor tunity to read into th e record our gov ernment's invest ment in the health system: $7.2 billion, total, for health care in Budget 2022–that is the most sig nificant health-care investment in the history of our province, $1 billion more than the previous gov ernment ever in vested in health care; $3.1 billion, pandemic supports to protect the lives and livelihoods of Manitobans; $630 million to strengthen the fight against COVID-19 and prepare for other variants and pressures on our health- care system; $30 million to add 28 a dditional beds to our intensive-care units, increasing our bed baseline up to 100 from 72.

With regard to the Diag nostic and Surgical Recovery Task Force, a very sig nificant investment, Mr. Chairperson: $110 million to address the surgical and di agnostic backlog, for a total of $160 million; $10 million to improve priority procedures and wait times; $4.9 million to expand the Concordia Hospital's orthopedic surgery program with a fifth operating room that will add 1,000 surgeries annually; $400,000 in the spine as sessment clinic to increase the number of assessments for Manitobans, ensuring

May 13, 2022 LEGISLATIVE ASSEMBLY OF MANITOBA 1979 900 patients receive their treatment or care plans sooner; a new mobile CT unit and two new mobile MRI units, which will soon deliver nearly 12,000 CT scans and over 7,000 MRIs annually.

We've also invested $90.5 million to add 259 ad- ditional nurse training seats this year as part of our plan to increase seats by 400; $11.6 million to add the next phase, permanently expanding our nursing seats in Manitoba; $4.3 million was also announce d for 37 additional nurse training seats at the Univer sity College of the North; $23,000 of financial aid for each internationally educated nurse applicant. Each in- dividual will get help with fees to obtain their licensure.

But in addition to these invest ments, we're hiring 35 more paramedics across our province. * (11:30) And for the member 's infor mation, in terms of capital investments, twenty-three–$2.3 billion in our targeted health -care capital plan for projects; $141 million for the St.

Boniface Hospital emergency department redeveloping that will triple the size of this emergency department; $8 million for the new acute stroke unit at Health Sciences Centre; $812 million to build, expand and fix our health-care facilities in all regions of our province in support of Manitoba's Clinical and Pre ventative Services Plan; $283 million for a 90 -bed new hospital in Portage la Prairie; $127 million for a 60- bed new hospital in Neepawa; $70 million to enhance and add 30 ad di- tional beds at the Brandon Regional Health Centre; $32 million to enhance and add 23 ad ditional beds at saint–Steinbach's Bethesda hospital; $64.4 million to enhance and add 24 beds at Boundary Trails; $31.6 million to enhance and add 30 addi tional beds at the Selkirk Regional Health Centre; $5 million for a new emergency department in Dauphin; $10.8 million to enhance and add 12 addi tional beds at the Lakeshore General Hospital in Ashern.

And, Mr. Chairperson, for the record, our govern- ment will be making more invest ments, more an - nouncements, to improve health- care services for Manitobans. Our gov ernment was elected to fix our services, including our health services, and that is what we're going to do with our record 7.2– Mr. Chairperson: The minister's time has expired. MLA Asagwara: Mr. Chair, I can 't, in good con- science, thank the minister for that response.

That was–I'm not –I think that was just an exercise in wasting time, and I 'm sure that there 's some element of strategy on the part of the minister to avoid answer- ing questions. My question was very clear; a simple question as to whether or not the minister thinks that the funding she is providing for acute care–and has been providing over the past six years–is adequate. For the minister to go on and list line-by-line funding announcements to me is–it's irresponsible, quite frankly.

It 's a poor use of the very limited amount of time we have in Estimates, and the minister should have been able to, with confidence, state whether or not she believes the funding they're providing for acute care is adequate. I don't understand where the minister thinks it 's reasonable or appropriate to spend five minutes to go over funding announcements instead of just providing a clear response to a very straight forward question. I would ask that the minister, you know, refrain from doing so.

We have a very limited amount of time in Estimates in this commit tee to get some questions answered on behalf of Manitobans, and this informa- tion's really important. So I'm going to move on to family medicine, and I'm going to take the minister 's previous response to indicate that she probably doesn' t think the funding that she and her gov ernment are provi ding for acute care is adequate. Otherwise, I think the minister would have clearly responded that she does, and she didn' t.

She did something else totally unreasonable instead of just providing a response, so I'm going to take that as the minister indicating that she probably r ecognizes that the funding to acute care is insufficient. In regards to family doctors, we know that primary care is so im portant. We know that people being able to access primary care by way of a phys - ician or nurse prac titioner is very im portant in terms of having good health-care outcomes in Manitoba. We also know it 's gotten harder to get timely access to a family doctor in our province.

Manitoba 's Family Doctor Finder actually shows a deterioration in that. Things were quite bad in this regard before the pandemic, as clinics were closed –clinics like on Corydon and St. B. Timely matching to a primary - care provider, to a physician, fell to less than 16 per cent. It's still taking too long at this point. Last year, nearly half of those folks seeking a family doctor waited for more than half of the target time to be matched, that target time being 30 days. What is the minister doing, actively doing? What steps is she taking to ensure timely access to primary- care physicians?

1980 LEGISLATIVE ASSEMBLY OF MANITOBA May 13, 2022 Ms. Gordon: I want to start by saying I am very disappointed to hear the infor mation the member for Union Station 's (MLA Asagwara) placed on the re- cord about acute care and my listing of the significant investments our government has made in acute care. The last time I checked, intensive-care-unit beds were in acute- care facilities, and the $30 million I mentioned to add 28 additional beds to intensive care is an investment in acute care.

The last time I checked, Concordia Hospital was an acute -care facility, and orthopedic surgeries–adding another operating room is acute-care funding. So, I'm very disappointed to hear the member try to dismiss that infor mation as not being funding of acute care.

And I know they –it hasn't been that long since the member left the health system to join pol - itics, but perhaps they have forgotten what encom - passes acute care. * (11:40) So, to the member's question about timely access to primary care, I'm pleased to see from the College of Physicians and Surgeons a steady increase in the number of physicians entering our province, in Manitoba, going from 39 in 2012 up to 89 in 2022. And all the other investments that our government has made in terms of allowing for virtual tariffs during the pandemic.

So there were individuals who ex - pressed concerns with having to go in person to see their physician during the peak of the pandemic, and our government and health system allowed for virtual tariffs to be billed for virtual appointments to occur. Under our Clinical and Pre ventative Services Plan we have a primary-care provincial clinical team that is looking at certainly ensuring that we are a wel- coming health system for new primary-care providers.

I know that myself, I do a lot of mentoring of young people from the Black com munity and have had an opportunity to work with what I understand is now a group of physicians that have formed this –a formal group of Black physicians that are helping other young people from the Black community to access our health system as physicians. And I was really pleased to hear about their program and how they 're helping with those efforts.

And then our distributed medical education program through the Rady faculty at the University of Manitoba, how we're supporting our U of M medical school in terms of ensuring that when prac titioners and physicians come to the system, they are being recruited and trained to work across the province and not just in Winnipeg. And I was pleased to join my colleague in Beausejour, where we welcomed nin e family phys - icians who started to practise in com munities across the Interlake-Eastern Regional Health Author ity.

So, four of the new physicians were graduates of the one- year medical licensure program for inter national medical graduates offered through the U of M, which is designed to integrate physicians who have practised internationally into the Canadian medical system. And the program allowed physicians who have practised internationally to better understand the needs of rural patients. And then the four graduates would be work- ing in rural and underserviced areas of the province and have made a four-year commitment to the region, and that was just last summer. So they 're just com- pleting their first year.

So we have many efforts under way. We will see more come to fruition through our clinical pre ven- tative services plan. We are committed to all our health-care providers at various levels of our organi - zation not just in Winnipeg, but in rural Manitoba, in northern Manitoba, to ensure that care is provided closer to home. And, again, we will continue to make our acute-care investments that I listed earlier and in support of the work that our clinicians– Mr. Chairperson: The honour able minister 's time has expired. MLA Asagwara: I'd like to as k some questions around the surgical backlog.

This is an area that I–you know, every person in Manitoba is in some way, shape or form impacted by, whether you yourself are waiting for a test or procedure of some kind, or you have a friend or loved one who is. A sig nificant portion– about 10 per cent–of our population is either waiting for a surgical procedure or diagnostic test. I'd like to point the minister to page 54 of her last annual report, so that's the report for 2020-2021. This shows that sp ending on what 's called priority pro - cedures wait times reduction.

So, under that category, the minister would know that, with a growing and aging population, enhancements need to be made at regular intervals just to keep wait times in check. That's ju st the reality of the ever -increasing aging population. And it 's not just happening in Manitoba, we know it's happening, you know, elsewhere, every- where, across jurisdictions. Unfortunately, after the PCs –after this minister and her government were elected, for several years the

May 13, 2022 LEGISLATIVE ASSEMBLY OF MANITOBA 1981 government did not make any enhancements in this area. As the minister would imagine, that means that there's going to be potentially poorer outcomes, chal- lenging outcomes, but certainly wait times got worse for priority procedures. This was actually reflected in CIHI reporting. And so, belatedly, we saw in the 2020- 2021 budget the PCs did announce $10 million for priority procedures. Unfortunately, quite surprisingly, shock- ingly, given the state of things and how we know things are progressing, that line–that budget line was underspent by 26 per cent.

So, you know, of course we know that Manitoba's wait times for priority procedures as a direct result of that have continued to get worse. They've been deteri- orating as a direct result. Can the minister explain, provide clarity around why this funding, $10 million that was budgeted for 2020-2021 for priority procedures, why it wasn't fully spent? Mr. Shannon Martin, Acting Chairperson, in the Chair Ms. Gordon: I t hank the honour able member for Union Station (MLA Asagwara) for the question. Before I answer that particular question, I do have an update on the patient flow reimbursement.

I would like to complete that, if I may. So, the $40,951 that I mentioned–so, all 65 claims have been approved, and that total number is –the $35,486 is already paid out, and the $5,465 is approved, and payment is in process. So I can state that the 65 claims is now completed. * (11:50) I also want to respond to the member 's question about the $10 million for priority procedures. That funding was provided in April of 2020. And as the member is aware, the pandemic was officially announced the month prior to that, in March of 2020, which led to a slowdown in procedures.

So to ensure that we continue to provide Manitobans with care–and that slowdown, just let me clarify, the slowdown in procedures was within our health system–we launched what we now refer to as our request for supply arrangements, or RFSAs, so that we could increase the number of procedures that were being done outside of the health system that was very–under an immense amount of pressure and was quite taxed.

To date, we have completed five request for supply arrangements for surgical services to address the backlog; 11,000 procedures have been contracted; $13.7 million has been spent and allocated to date: $8.1 million for the first four RFSAs, $5.6 million in service delivery organizations on priority procedures, including hips, knees and cataracts. We are now work- ing on our sixth RFSA, which includes endoscopy; cataracts; pediatric general surgery, dental and ear, nose and throat; outpatient spine procedures; adult ear, nose and throat and general surgery.

So in terms of the dollars that the member men - tions that was underspent, we have –we were in the midst of a pandemic, and the system was undergoing an unprecedented change, in terms of redeployment of staff, in terms of a decrease in surgeries. And we moved to an RFSA process, have been able to use the RFSA process to sign agreements such as the one we're working on now with Maples Surgical Centre, which will provide women with hundreds of gynecological surgeries. The Sanford Health in North Dakota has helped to provide spine surgeries.

We 're doubling the number of anesthesia clinical assistants in the province, working with our colleges for nursing and regulatory colleges to look at staffing models. And so we have certainly been asked to pivot and be innovative and creative, in terms of being able to provide surgeries and services to Manitobans. We have that money in our budget and, you know, the Diagnostic and Surgical Recovery Task Force is working to ensure we continue to provide surgeries for those priority procedures.

An update will be coming from the task force very, very soon and more good news for Manitobans who are receiving their surgeries and their diagnostic tests. And, again, I thank all the health- care pro fes- sionals that are–have returned to their programs, their acute-care facilitie s, their personal -care homes, all across this province, for the incredible work that they did to make these RFSAs and the procedures that have been done a success, and we will continue to work closely with them as we move forward– The Acting Chairperson (Shannon Martin): The honourable member's time has expired.

MLA Asagwara: I thank the minister for that response. I would like some clari fication, because that $10 million for priority procedures was actually seen again. So, it appears again in the budget for 2021-2022, so last year's budget.

1982 LEGISLATIVE ASSEMBLY OF MANITOBA May 13, 2022 Can the minister indicate how much of that funding is the department projecting has been spent? Mr. Chairperson in the Chair And, interestingly enough, that same budgetary amount, $10 million, appears in the budget for this year; for 2022 and '23. Does the minister believe that that funding will actually be spent in its entirety for this year?

So, can the minister provide clarity around whether or not the $10 million, which appears again for last year's budget, how much of that is the depart- ment projecting will be spent, and how much of the $10 million that 's in this year 's budget –or does the minister think, rather, the $10 million in this year 's budget will be spent in full? Ms. Gordon: My apologies –I'm not sure why my screen blanked out. I thank the member –honourable member for Union Station (MLA Asagwara) for the question.

In terms of the question about why it's appearing year after year, this is an ongoing commit ment that came from the wait ti mes report in 2017, and that request–that recommendation was part of that report that came forward from front-line physicians, that our government would continue to invest $10 million on an annual basis, specifically for priority procedures. For–the numbers are still being finalized for 2021-2022, but what we're seeing right now is that we will be surpassing the amount of the $10 million. So the $10 million will be fully spent and more.

And for this year, again, it 's a commit ment of $10 million for priority procedures, and I anticipate that the $10 million will be fully utilized. We have many Manitobans that require care and many of those are priority procedures, and we want to ensure that all of those funds –so to the member 's question, ' 21-22, we're on track to fully utilizing all of those funds, and again for '22-23. Thank you so much. MLA Asagwara: I thank the minister for those responses. I know that she said that they would fully –they would go over and above the $10 million allocated in last year's budget.

If the minister could provide clarity around how much has been–what they do have, in terms of what has been spent, so the most recent calculation that they have would be great, in regards to 2021 and 2022. * (12:00) I'd also like to ask t he minister about funding priority procedures –sorry, I apologize. Last year 's fiscal year, the government–this minister and her gov- ernment announced a general annual contribution for all procedures of $50 million specific to the surgical and diagnostic backlog.

This year's budget presentations–so, 2022-2023– shows the last–the line, sorry–the line for last year as $40 million and not $50 million. So a discrepancy there. In addition, in March, at the very end of fiscal year 2021- 2022, the minis ter reported that $13.7 million of the $50 million had been spent or allocated to date. That's what the minister reported. So can the minister explain why the Estimates of expenditure for this year show that last year 's com- mitment to the surgical and di agnostic backlog was $40 million and not 50, and that's on page 156 of the budget Estimates of expenditure.

So I just was seeking clarification, if the minister could I –could clarify for us–if the minister could clarify for us –and I've now lost my tra in of thought on that –yes, sorry–for last year, if the $10 million for priority procedures, where things are at in terms of that spending, that would be great, just whatever calculation they have to date for that. And then just clarify why in–on page 156 of the budget Estimates for expenditure, why it says $40 million for the backlog and not 50 as indicated. Ms. Gordon: I thank the honour able member for Union Station for the question.

I do want to answer the previous question that they asked, and that wa s about the 2021 priority procedures and how much we are estimating to spend against the $10 million budgeted. Preliminary esti - mate for 2021-22 is $10.9 million. Again, that number has not been finalized so I em phasize the word esti - mate. I also want to answer the subsequent question about the $50 million, and so on an annual basis our government is supporting the recommendation of the wait time report with a $10 -million invest ment.

So in 2021, there's $10 million for priority procedures, and then health system capacity enablement was $40 million and that totaled $50 million. So the $50 million referred to in 2021 was a com- bination of two things: the $10 million for priority

May 13, 2022 LEGISLATIVE ASSEMBLY OF MANITOBA 1983 procedures and the $40 million for the COVID backlog. Thank you. MLA As agwara: Thank you, Minister, for that question. Can the minister update us on how much of that funding was actually spent and not just allocated? And I'm speaking spe cifically–just so that I 'm clear –I'm speaking spe cifically to the diag nostic and su rgical backlog funds that the minister had announced–the $50 million that were announced by the minister, rather. So, I'd like the minister to be clear on how much was spent directly on surgeries and procedures.

So, an update on how much of that funding was actually spent, not just allocated, and clarity around what was spent directly on surgeries and procedures. Previously–and I'll give this as an example. We've raised this recently that, previously, the gov ern- ment has suggested things like doctors ' billings for meetings were being counted as part of that $50 million. So I really am just looking for clarity around how much was directly spent on surgeries and procedures. Thank you. Ms.

Gordon: I'm going to have to spend a bit of time explaining how medical remuneration works for our diagnostic and surgical recovery backlog.

So, of the $50 million, $13.1 million was for the first four request-for-supply arrangements that led to 11,000 procedures which came from this, which include cataracts –endoscopy; cataracts; pediatric general surgery, dental and ear, nose and throat; outpatient spine procedures; adult ear, nose and throat and general surgery; $2.1 million for initiatives through the Diag nostic and Surgical Recovery Task Force have totalled, fo r the initial activity like FIT testing and spine surgery, $34.8 million for medical remuneration for physicians. And so, you know, let's–I'll give you an example.

So, someone has a cataract done at western surgical centre. We bill–western surgical centre bills us for the surgery time, for the space –oh, I'm gone now. Okay. We've got to sort this out, guys. There 's got to be L-D-I-S power– Mr. Chairperson: We can hear you, minister. Ms. Gordon: Thank you, Mr. Chairperson. Can I continue without video? Mr. Chairperson: We have video. Ms. Gordon: Oh. We –I can 't see you. So I 'll just continue.

So, if western surgical centre, for example, does a cataract surgery, they will bill us for the surgery time, for the surgery room and equipment, and then the doctor that performed the cataract will bill us under medical remuneration. So the $34.8 million can in - clude anything from the person seeing their physician to begin the process leading up to their surgery.

So I just want to clarify that, because there seems to be some misinformation in the public sphere about the monies that are being paid out under medical remuneration, but it is for individuals who might even be starting their journey towards their surgery, have completed a test, where we are billed under medical remuneration.

Thank you. * (12:10) MLA Malaya Marcelino (Notre Dame): Advocates, IENs and even the former fairness commissioner have identified specific require ments and processes that have been mandated by CRNM, or the College of Registered Nurses of Manitoba, that have acted as unfair barriers to IEN accreditation. Last spring, your government made some amend- ments–passed some amend ments to The Fair Registration Practices in Regulated Professions Act, and that legally allowed for more g overnment dis - cretion in deter mining these out comes for accredit - ation for these regulated professions like nursing.

Has the minister availed of these new powers to carefully present compliance orders to CRNM to compel them to remove certain unfair ba rriers that advocates, the former fairness com mission and IENs themselves, have raised to you? And if so, could you please describe the nature of those compliance orders? Thank you. Ms. Gordon: I thank the honour able member for – from Notre Dame for the question and welcome her to the committee table. Internationally educated nurses and supporting those nurses is certainly a priority for our government.

That is why we have made available $23,000 for each internationally educated nurse to gain licensure and to practise at their full s cope here in this province. And we continue discussions. I was pleased to meet yesterday with the Association of Regulated Nurses of

1984 LEGISLATIVE ASSEMBLY OF MANITOBA May 13, 2022 Manitoba, talking about how we can better support our internationally educated nurses and it was in the first half of 2021 that the first compliance letter was issued to the College of Registered Nurses of Manitoba.

Since being appointed Health Minister in August of 2021, I 've had several meetings with the college, and my latest meeting was May 11th, just a couple of days ago, where we both spoke about the need to streamline the process, to work with our colleges and our Red River College and our advanced education in- stitutions to streamline the process to licensure for our internationally educated nurses. So, conversations continue to be held.

We also have a tripartite assistant deputy minister working group that has been formed between the Minis try of Health, the Ministry of Advanced Education, the min- istry of economic development and trade. So everyone is coming to the table because it is going to require that whole-of-government approach to addressing the needs of internationally educated nurses, as well as working with the colleges and the Manitoba Nurses Union, I've had many discussions with them, as well.

So, we continue to work through the challenges that we have seen, and I stand committed to ensuring that we stream line the process to licensure for our internationally educated nurses. Thank you. MLA Marceli no: Thank you for that response, Minister. And speaking of the IENs in Manitoba Project portal that was rolled out last summer, this is a project that would purportedly provide funding to Manitoba IENs for the various steps and requirements involved in the recognition and 'registation' process.

I'd like to know how many folks have been suc - cessful applicants to this project and how much funds, in terms of the grants, have been disbursed to this date? Mr. Chairperson: The honourable Minister of Health (Ms. Gordon), we have no video or audio of you. [interjection] We've got video but no audio. The honour able Minister of Health. Could the minister unmute? Ms. Gordon: I'm pleased to answer the hon ourable member for Notre Dame 's (MLA Marcelino) qu es- tion.

This program, which is one of the reasons we have this tripartite working group, is managed–the funds and the number of individuals that are moving through their portal is handled under the De partment of Economic Development, Investment and Trade. So that information would need to be taken under advise- ment or asked during their Committee of Supply. Ms. Amanda Lathlin (The Pas-Kameesak): I just want to clarify– An Honourable Member: Amanda, can you just say that we'd like to take it under advisement? Ms. Lathlin: Oh, okay.

We 'd like to take this under advisement– An Honourable Member: The previous question under advisement. Ms. Lathlin: With the previous question, minister. Mr. Chairperson: The honour able Minister of Health–we cannot hear the minister. Could you be – unmute? * (12:20) We are working to get your audio restored. Could the minister check if they're muted because we cannot– Ms. Gordon: Can you hear me now? Mr. Chairperson: We can hear you now. Ms. Gordon: We can take this–these questions under advisement and seek that infor mation from another department, which is where the infor mation is held. Yes, we can do that.

Ms. Lathlin: I had walked in in the middle of num - bers when you were talking about trans portation. I'm from–I would say everyone knows here I 'm from northern Manitoba. Is there a difference between that NP, Northern Patient Transportation Program versus what–the con- versation I had just walked in when we were quoting $70 per night all otted for patients from northern Manitoba? So can you clarify that? Is that two differ- ent fundings or is that the same? Ms. Gordon: Can you hear me now? Okay, and I thank the member for The Pas -Kameesak for the question.

So, you may have entered the room when we were talking about the financial hardship supports for individuals that are –experience patient transfers,

May 13, 2022 LEGISLATIVE ASSEMBLY OF MANITOBA 1985 interregional patient transfers. The Northern Patient Transportation Program is different. So that was esta- blished in 1972 as a reorganization of the former patient air trans portation program, and it covers in - dividuals who are residents of Manitoba located in one of the applicable RHAs and are registered with Manitoba Health.

And individuals can receive a travel subsid y for certain travel expenses incurred while travelling to access an insured benefit, being referred by a phys - ician for a medically necessary inter vention not available at the individual's community, subject to the northern patient transport policy, t ravelling to the closest ap propriate location and travelling by the lowest cost travel option that is medically appropriate. So that–they're two–it's a different program. Ms.

Lathlin: Since it's a different program, can you name–are the rates still the same, as in hotel and meals per diem, because I can tell you for a fact, when one cannot cover the other half –usually hotels go for $130 a night; depends where you are. Most of our people where I come from can't afford to come down, pay for the hotel. And meals is like $8. You know, it just forces people to go eat at fast food restaurants at that rate, with our diabetics.

Is there going to be a time where these rates can go up so our patients from northern Manitoba will feel more comfortable and safe and more ensured that they can receive their medical needs instead of having to have money in their pocket or money in their bank accounts? Ekosi. Ms. Gordon: I thank the honour able member for The Pas-Kameesak for the supplementary question. So the–this is a travel subsidy; it's a transportation subsidy to residents who have to travel long distances to obtain medical care in the province.

First Nation Inuit health covers transportation for on-reserve status clients through the Non- Insured Health Benefit Program. So this program is unique in Canada. Manitoba is the only province that provides a trans - portation subsidy. Again, it's to residents who have to travel long distances to obtain medical care. Ms. Lathlin: I'm very aware what the–this program is all about.

But, again, to–in order to prevent people from neglecting their health by not having money in their pocket to attend these long- awaited ap point- ments for our people, not just for Indigenous people, but all of our northern Manitoba –I don' t live on reserve; I live across the river, and I 'm–I would have to go under NPTP, not on reserve, which is just across the river. It's ridiculous. Anyway, will these rates be increased so we can feel safe and comfortable to travel to Winnipeg, access health, instead of having to worry about money, cancel ap pointments and hope you have money in your pocket next time?

Because this really is detrimental to our health–money. Ms. Gordon: I thank the honour able member for The Pas-Kameesak for the question. And in my time in the health system, I travelled quite extensively in the North and in rural Manitoba, as well, and I 'm very familiar with the patient trans - portation program and that it is a trans portation sub- sidy; it does not, for the member 's information, does not include meals and ensuring a person has cash on hand to–for out-of-pocket expenses. It's specifically a travel subsidy.

And just want for the record to state that our gov- ernment has doubled the NDP 's funding of the pro- gram from $ 7.9 million to $18.1 million. So we are investing in the program. We recognize that individ - uals need to be able to travel from their remote com - munities into Winnipeg and other locations for care. Again, it 's a transpor tation subsidy; it 's unique in Canada. See, we're the only province that provides a subsidy, and again, it's to residents who have to travel long distances to obtain medical care in the province. Mr. Chairperson: The hour being 12:30, committee rise.

ROOM 255 EDUCATION AND EARLY CHILDHOOD LEARNING Mr. Chairperson (Brad Michaleski): Will the Committee of Supply please come to order. This sec- tion of the Committee of Supply will now resume con- sideration of the Estimates for the De partment of Education and Early Child hood Learning. Question- ing for this de partment will proceed in a global manner. The floor is now open for questions. Mr.

Nello Altomare (Transcona): It's good to be back this Friday morning looking and getting into the Estimates for Edu cation and, you know, just deter - mining the direction that the de partment is going in and what we can expect moving forward for '22-23. I do want to acknowledge, Mr. Chair, we do have people in the gallery today, and I just want to welcome

1986 LEGISLATIVE ASSEMBLY OF MANITOBA May 13, 2022 them to the committee room because this is an impor- tant part of democracy, one that not a lot of people get to see and witness. And today it's, like I said earlier, it's great to have people in the gallery. So, welcome. We'll just get right into this, Mr. Chair, and we'll also continue with questions that are global in nature. I will say, I'm finding it somewhat interesting because I know this government does talk about transparency, need for the public to know how de partments are working and the pieces included in that.

So, when I'm talking about that, I'm thinking and reflecting back on the Estimates book, Mr. Chair, back in 2019- 2020, the Estimates book for the Department of Education was actually quite extensive and granular, found it quite informative and did give a real clear direction as to where the government was going with the Department of Education. Now, two short years later, we have an Estimates book that is somewhat less concise, and really difficult to discern exactly what direction the de partment is going in.

So, I would like to ask the minister, my first ques- tion is, how is this Estimates book able to provide the necessary detail to deter mine what direction the de - partment is going in? Hon. Wayne Ewasko (Minister of Education and Early Childhood Learning): Good morning, every- one, and happy Friday. And again, yes, absolutely, Manitoba is a great place to live, work and play and raise a family, Mr. Chair. And so, just to concur with the member from Transcona, that's the beauty of being here in Manitoba and being able to have people in the gallery and witness the demo cratic process, here.

And I think, more and more, we need to do–I know –I can't really speak to some of the policies and ways of doing various different things and how we educat e the public on the processes and the various steps of gov- ernment here, Mr. Chair, but I know we, in the educa- tion system, are working on various different things to get information out to the public so that they're more than aware of the different steps and how government works. And that goes with com mittee rooms and absolutely every thing. And especially, you know, during the Estimates process.

So, to answer the member's question, so, the for - mat for Estimates and for the Esti mates booklets, the budgetary supplemental expenditure documents, the government changed the format in '21 -22, so that's what the document is in front of you, my friend from Transcona. But, in addition to that, what we have is the balance scorecards, which basically is totally transpar- ent; it's available to the public. And those balance scorecards also have targets attached to them so that everybody can see exactly what are the steps, the goals, the missions and the progression as far as what the department is doing.

And as, you know, the member knows, in January, my de partment, Edu cation and Early Childhood Learning, was created. We brought in Early Childhood Learning because it is just a great synergy, it totally makes sense, and absolutely have to applaud Premier Stefanson for that move. * (10:10) Thanks, Mr. Chair. Mr. Chairperson: I just, like, want to remind the Minister of Education that we can't use proper names, so for Premier Stefanson, please just use Premier. Thank you. [interjection] Mr. Altomare: I'm glad that we're working out all of the machinations and how to, you know, conduct busi- ness this morning.

It's always a lesson, because, you know, we don't nearly have enough time in Estimates and to get down to the nitty-gritty here. I will talk a little bit more and ask the minister a little bit more about assessment. We do know that during the past 26 months it's been a challenge in schools for assessment, and I would assume for the department as well, Mr. Chair, because a number of assessment tools have had to have been suspended, not undertaken. And this, of course, gets back to the department because the de partment, then, doesn't know how students are progressing, what stage they're at, et cetera.

And so, with the challenge of the past 26 months, what type of assessment data–other than report card data, which I do know that the de partment collects– what other pieces of assessment data has the depart - ment been collecting so that they can get an idea of how students are progressing in Manitoba? I'm thinking spe cifically of the grade 3 assess - ment that would go on, I'm thinking of the middle years assessment and I'm also thinking of the assess - ments that were used in high school. Mr. Ewasko: You know, the member knows–I mean, he was an early years teacher and an administrator for

May 13, 2022 LEGISLATIVE ASSEMBLY OF MANITOBA 1987 his 30-plus years in the education system. I mean, this year would have been my 28th year as a teacher and guidance counsellor and working with students at all different levels, Mr. Chair, you know, with student services, a little bit in the early years for myself, but mostly middle years and senior years. But I'm not quite sure–the member might need to put a little bit more on the record in regards to what he was referencing. So I'm going to just basically go with that he was talking on the positive side of hall–how all this works.

But he knows that our teachers, educators, staff, they assess and reassess on a daily basis. They work with their students. You know, as far as the pandemic goes, even before the pandemic, teachers were finding new and innovative ways to make sure that that learn- ing had continued before the pandemic, during the pandemic and post -pandemic. I mean, we're having those conversations with school boards, school divi - sions, educators.

The department has met with all 37 school divi - sions to make sure that our framework for learning– which, again, you know, the member from Transcona doesn't reference all the good things that are going on, unfortunately, but that's okay. The day after, when we launched the action plan on April 20th, we actually also launched the framework for learning, which all school divisions, school boards and senior admin had absolutely applauded. So with that, you know, I know he mentioned also the assessments at the early years level and the middle years and also the senior years.

So the grade 3 and 4 assessments have started again, and keep in mind, this is on top of the day -to-day assessments that teachers and staff are doing, and the 7 and 8 assessments have started again. We have suspended the grade 12 assessments right now, but then again, that's –that doesn't exclude any of the day-to-day assessments that are going on from our hard-working teachers and staff at the various different levels within our K -to-12 system. And we just continued to have that dialogue, open dialogue with our education partners at various different levels, Mr. Chair. Mr.

Altomare: What I was asking for spe cifically, Mr. Chair, is, has the department collected any assess- ment data from school divisions, and–in the sense, during the pandemic? And, you know, if not, you know, not to provide a reason but to–at first, I kind of want to know if data has been collected. And then, if it hasn't been collected, what's the p lan moving for - ward for the department to know what level students are at? * (10:20) Mr.

Ewasko: I mean, the member knows how chal - lenging it has been over the last couple years and especially–you know, and for all Manitobans and Canadians and people al l across this–the world, basically. You know, to spe cifically talk about assessments as he asked for a specific answer. So, here we go. The 3-4 assessments had started again as far as the provincial assessments; that was getting collected in the fall. The 7 -8 assessments had started getting collected in the winter and we're getting that informa- tion. Again, teachers are assessing and reassessing on a day-to-day basis.

We're also taking a look at, of course, the K to 12– the commission basically asked for the provincial en- hanced programming, basically a system-level check. And, again, with the framework for learning, it definitely highlights the fact that we want to support teachers in their classrooms as well, anything that they need to build upon what they already know in regards to assessing and all of that type of stuff. We are still tracking credit attainment at the grade 9 level. We're still checking and collecting data on the graduation rates.

You know, we are looking on–again, the frame - work, and I'm hoping, you know, again, it's been a few days since we've been in Estimates and I'm hoping the member took it upon himself to take a look at the framework for learning and maybe read the action plan, and then also our Indigenous inclusion fra me- work for learning called Mamàhtawisiwin. So, hope- fully he is–if he hasn't, hopefully, he's asked his staff to give him a bit of a

summary on that. And again, I'm more than willing to have a briefing with the member. I know that we've had– shared many great conversations in regards to educa- tion in the past, and definitely open to any type of briefing that the member would like to have on any of the topics or all the topics that I've spoken about. Mr. Altomare: I do know that there was an an - nouncement earlier in the year regarding moving assessments at the high school, or at the senior years, from grade 12 to grade 10, and that was interesting. I would like to ask the minister, what was the assessment de partment thinking about in the

1988 LEGISLATIVE ASSEMBLY OF MANITOBA May 13, 2022 Department of Education in moving that from grade 12 to grade 10? What is the thinking behind that, and what do they wish to accomplish with that? Mr. Ewasko: So, I'm hoping that the member from Transcona–my–you know, my colleague in the educa- tion world, I'm hoping he's not going down the path of trying to say that teachers aren't assessing. So I'm going to answer his question and then get into an ad- ditional teachable moment, as we say at times.

So, basically, what had happened is, you know, unlike many, many, many years ago, we have–in our government, we have had the oppor tunity to bring people in and to collaboratively have conver sations about education. So, there was a summit –there was a literacy and numeracy summit in 2018–maybe the member's aware of that, maybe he's not, but that's okay. There was a numeracy-literacy summit in 2018, January of 2018, and there was well over 800, I believe, parti ci- pants that was engaged. And they over whelmingly suggested that the grade 12 prov incial assessment be moved to the grade 10 assessment.

And for many years, I mean I–I taught precalculus at the high school level myself, and even when I was teaching precal back in the mid 2000s, 2005- ish, somewhere in there, to 2008, maybe even a bit earlier, I was always wondering, like, so we're doing this provincial assessment, and I know it's a snapshot, but we're doing assessments on a day -to-day basis–why were we doing a provincial assessment snapshot at the end of their K to 12?

Now, part of that rational e makes sense to me, I guess, right–they want to see, you know, how the students are doing at grade 3, 4, how they're doing at 7 and 8, and how they're doing at grade 12. So the overwhelmingly–advice from the summit, also from the K -to-12 com mission plus –and, again, I –I'm re - ferencing that action plan, because it's a great K-to-12 action plan, which is a road map to student success – it's mentioned in there as well, to move that grade 12 snapshot assessment to grade 10.

And I'd like to actually quiz the member, but I know this is–that's a little bit different, but in his pro- fessional opinion, why does that make sense? It makes sense to me, because again, it's a snapshot. All these teachers are doing assessments at every grade level, on a day-to-day basis. And why are they doing that? So they can assess where their students are at, be flex- ible and nimble within the curriculum, to be able to change and adapt what they're teaching to each in- dividual student's needs.

So, the recommendation to move it to grade 10 is so that, okay, we're taking a snapshot here at grade 10, they've got another two years of secondary school, is there any gaps, is there any other learning needs that these students need, any other supports that this –that the teachers need? That's pretty much it. Totally makes sense. I know that the member from Transcona would more than agree with me. Thank you, Mr. Chair. Mr. Altomare: I'd just like to reiterate that I was genuinely curious as to some of the rationale behind that.

Certainly, we all know that teachers assess con - tinually and they have a variety of tools. But this is, more specifically, I was trying to get to the thinking that the De partment of Edu cation has, because I do know that the department wants to collect the data so that they can make informed decisions based on the data that's collected. And because we've been in this –past 26 months, have been in this up–I know, kind of an upside-down way of learning that I was genuinely curious as to the thinking behind t hat.

And I was –I'm happy to hear what the minister said in his response, and I'm also willing to take up the minister on his offer to have another briefing and talk about assessment. I would certainly look forward to that, Mr. Chair, because this is an im portant piece, especially moving forward, right? Because all of this, Mr. Chair, impacts, even - tually, the supports that we're provi ding kids in schools. And, of course, the best of support for kids in schools is that classroom teacher, that teacher in front of them. * (10:30) And we do know that that's certainly been chal - lenged lately, especially since 2016.

We've been see- ing some real cuts and constraints to the public school system. And I know assessment data is critical in en - suring that we plan not only for success, but also have a plan in place that is proactive in nature, that is based on assessments that have been collected for a number of years so that we can make informed decisions, so that we can provide the services that kids require in their classroom experience. So I look forward to an invitation from the minis- ter regarding that briefing. He knows how to get ahold

May 13, 2022 LEGISLATIVE ASSEMBLY OF MANITOBA 1989 of me and, like I said, Mr. Chair, I'm looking forward to that. I do want to stay on this sort of pandemic -theme piece and how it's impacted kids in school and kids out of school. We do know that the pandemic had a significant impact, Mr. Chair, on attendance and enrolment. A number of parents, at the height of pan- demic, decided to home-school their children.

And, in this vein, I'd like to ask the minister: Can his de partment provide a pre -pandemic number of home-schooled kids, and how does that compare to the current number of kids that are being home - schooled? Mr. Ewasko: With the five minutes of questions and answers–so I've got a couple little notes and tidbits that I wanted to mention and just to show that, my friend from Transcona, that I am listening to him. So I'll start, I guess, up at the top.

First of all, I totally know that the questions that he was asking in regards to assessment and, you know, as I mentioned to him earlier –and I think he knows that I'm also being sincere–as he is on his questioning, I'm being sincere about the briefing. So we'll defin- itely, you know, get him that briefing on that frame - work for learning document and additional things, for sure. You know, I do have to say, in regards to the member continuing to put misinformation on the record–and as he continues to do it, I'm hoping I don't have to slide that word to disinformation, that he's doing it on purpose.

But in the last two years, we have funded education to the tune of about $327 million of more funding over the last two years –that's over a 17.2 per cent increase. You know, when he's asking the question spe - cifically–so, I'm sort of going in chronological order to how he was asking the questions. So in regards to enrolment, in 2019- 20, there was home -schooling– there was just about, well, 3,689 students; in 2020-21, there was 8,027 students; in '21 -22, we had already seen the majority of these students start to make their way back, so that's 6,149.

And, you know, of course –the member from Transcona being a former administrator, he knows that at the end of September of each year he has to try working with the school di vision to get the numbers into the department as far as the enrolment within the schools and all of that type of stuff, and we know that those numbers sort of trickle in, I guess, throughout October of each school year, and so that 6,149, that is the number that we have reported and trickled in from this past October.

But we also know that school divisions and school boards and school leaders, including us in the department of working–have been working very dili- gently and closely with communities to make sure that they're very much aware that–and that we're strongly encouraging students to get back into the public school system. And so we anticipate that those num - bers are quite a bit less today. We'll know more come this fall, of course.

But also, just to assure–or to anticipate a potential future question that the member is going to ask, we also, within that $327 million of funding–the 17.2 per cent increase to Edu cation–we also were making sure that we were funding school divisions to basically balance off that reduction in enrolment due to the pandemic pressures.

So, schools and school divisions had not seen–you know, they –we worked quite closely with the school divisions to make sure that–because, of course, funding, as the member knows, generally, under the present model, which we're doing a funding review, is based on enrolment, and we just made sure that no divisions were penalized for a reduction in enrolment due to the pandemic. Thanks, Mr. Chair. Mr. Altomare: Those numbers are quite interesting. I want to thank the member for providing those num- bers; I didn't realize that it was that high in 2021.

And I do know that the department said that they were using the numbers from before the pandemic to determine base school fundi ng. That's a very im por- tant number that every school here looks forward to seeing later in October based on a number on September 30. I would like to ask the minister, then, for September of 2022, are we going to go back to that September 30 number, or will we continue using an average of the previous years? * (10:40) Mr.

Ewasko: In regards to funding –and I believe I understood the member's question correctly –is that– and just to clarify to him, and again, he knows this because he's an administrator–was an administrator. So, the funding for school divisions was an- nounced in February to all school divisions, and as we've been doing over the past two years since the pandemic had started, we are taking a look at

1990 LEGISLATIVE ASSEMBLY OF MANITOBA May 13, 2022 numbers. We are watching those numbers. We are in constant com munication with school boards and school divisions and senior leadership. The de partment and I are –and as we moved forward we're going to continue to see what impacts the pandemic continues to have on our enrolment within schools. And so those numbers are adjusted as more infor mation comes in, and how the pandemic has actually impacted–or as the students come back to public school system. Mr. Altomare: What the FRAME documents outline, Mr.

Chair, is a steady decline in the provincial contri- bution of public education. In 2015-16, the provincial contribution to public educa tion was 62.4 per cent, or $1.404 billion. In 2017 -18, it went down to 60.3 per cent, and the actual dollars that the provincial government contributing to public education remain- ed flat at about $1.4 billion. Mr. Chair, in the latest FRAME, the prov incial contribution is 58.2 per cent or $1.45 billion, which means since 2015-16, the actual prov incial contribu- tion to public edu cation has only gone up roughly $50 million. That's in the FRAME.

In February of 2022, the gov ernment did an- nounce a 1.34 per cent increase to base funding to public education in a high interest environment, in an environment, now, since 2015- 16, where inflation is reaching close to 22 per cent. An extra $50 million over the six years doesn't cut it to meet the needs of students. It's outlined in the FRAME as to those numbers, Mr. Chair. It's quite clear. Right now, this core service of gov ernment is being starved–starved–of the human resources that it needs, Mr. Chair. We're seeing it tangibly evidenced by teacher layoffs. We've outlined those in question period.

They're well known in Seven Oaks, Brandon School Division, a number of smaller rural school divisions. The minister likes to talk about a 300 -and-some- thing-million-dollar increase to a budget. That's factually untrue, Mr. Chair. If that were the case, teachers would not be being laid off. EAs would not be losing their jobs. We still have a very difficult time understanding how, as we emerge from the pandemic, a 1.34 per cent increase in base funding is going to meet the needs of students, Mr. Chair. And this is a real concern.

When a–when this gov ernment took office in 2016, they began a systematic reduction in support for schools, fiscal support for schools, shifting the burden onto school boards –school boards then having to raise property taxes –but then tying the hands of school boards because they couldn't raise them enough to make up even just to maintain their base level of what they had the year before in human resource complement. So my question for the minister, Mr. Chair, is how is a 1.34 per cent increase in base funding going to meet the needs of our students coming out of this pandemic? * (10:50) Mr.

Ewasko: You know what, I more than appreciate, actually, this question coming from my friend from Transcona, because, you know–so when I was elected in 2011, many of the funding models –I mean, I was actually in that chair that he's sitting in back quite a few years ago, Mr.

Chair, as Education advocate, and some of the cases –I mean, I was still relatively early on in my political journey, and he knows as well as I know, it's amazing on how many things that you end up learning and, you know, nobody's got any textbooks on this stuff where you can actually go and read up on a lot of this stuff, but there is infor mation out there.

And so when the member puts on the record various different numbers and things, and, I mean, he talks about the FRAME report which is –which, you know, when you talk about the FRAME report, and the one that he–the member is referencing, this is from 2020-2021, and that is a budgeted FRAME report.

What is not included in the FRAME report –and you know what, I'm going to give the member a bit of a pass on this, because I didn't know necessarily all of the inner workings and the addi tional fundings that went from the prov incial government to school divi - sions and school boards so that they could then make the decisions that they make.

And the member references teachers and EAs and all these support staff within school divisions, and he knows that it's –because I know that he doesn't want me interfering with school boards and, you know, trustees' decisions on what they do with the money that they're given. And so the FRAME is a budgeted amount, and this is sort of operational dollars, but in addition to that–in addition to that, there is a–various amounts of money that is allocated and given towards school divisions, so I'll just list off a couple.

May 13, 2022 LEGISLATIVE ASSEMBLY OF MANITOBA 1991 We know that –and he knows –that the funding model is old and antiquated, and we're under–in pro- cess to start to redevelop, speaking with our education partners all across the province of ours to come up with a better funding model. And what that means is taking that chunk of money and being able to send it out to school divisions and school boards more fairly and equitable. It is unfortunate that the previous gov- ernment didn't feel that they ever need ed to actually embark on this, but we're doing it.

So what the member is almost deliberately not putting on the record, but I'm going to give him a pass on that, is that we have also, in addition to the budgeted amount of monies, we have given $80 million in January and an addi tional $77 million to school divisions outside of the base funding through that formula. Why did we do that, you may ask. Well, we did that because the funding model. If you just threw that money into the funding model, it would go back into that funding model and then not be dispersed fairly and equitably where that money is needed. So, that's why we did that.

Those types of dollars do not show up in the 2020-2021 budgeted FRAME documents. We also, throughout the pandemic, w e had al - located over $250 million to support our school divisions, schools and school boards. Also–what is also not included in the FRAME report is capital expenditure, all the monies that is spent on schools in regards to capital. So, in the last two years, our capital allotment was $160 million, and we've added $100 million on top of that each year. So we've been–we've upped the capital by $260 million for the past two years. We also, Mr.

Chair–I'm going to run out of time– we also increased our ad ditional funding by $1.6 billion over four years. I'll explain more in the next answer. Mr. Altomare: I think what I'd like the minister to understand is the real -life consequences. What hap - pens at a school level when a prov incial government isn't a willing partner in ensuring that students get the support they need? A 1.34 per cent increase in base funding has direct impact on the classroom, Mr. Chair. I outlined some of them. I can go into a more granular level, at the school level.

I can say in some middle schools that are about four to five hundred that are in my 'constit,' we're seeing a reduction in student support teachers, middle schools going from two resource teachers down to one and a half, losing block funding in order to support kids with additional needs, and then, of course, that having an impact on a number of EAs that can be in a school. These are the real -world impacts of that. Capital funding is one thing, but that doesn't keep the lights on in schools that are currently functioning.

And what we're seeing, as clearly outlined by the FRAME documents that the minister referred to, is a systematic decline in prov incial funding, base fund- ing, for schools. And that has impacts on the class - room, has impacts on kids and families. * (11:00) This question was not about the department inter- fering what school boards are doing, this question was about having a real partner in the prov incial govern- ment to ensure that kids get the services that they need, Mr. Chair. With this level o f funding, i t's be - coming more and more of a challenge after five to six years of this.

We are at this point now where, not only is the system tired because of the pandemic, but the system feels like it just can't provide the support necessary. Here's an other tangible example, is that we're starting to see school boards having to make really, really, difficult decisions now, because of the in- creasing fuel costs. And that is a direct result of forces that are out of the control of that school board, so we're talking about places like Evergreen, Lakeshore, where trans portation–where their trans portation– transporting a majority of their kids, having to make some really difficult decisions.

And so I'll ask the minister again: How does a 1.34 per cent increase in base funding respond to the needs of kids coming out of this pandemic? [interjection] Mr. Chairperson: Order. Order. Mr. Ewasko: So, it's evident to me that my colleague, my friend from Transcona, the MLA for Transcona, is doing a little bit of cherry-picking. And so what I mean by that is that, on one hand, he's talking about the FRAME report from 2020-2021, which is based on the budgeted amounts, not the ad- ditional funds that have come into play; now, on the other hand, he's talking about fuel prices. So, can he please focus?

I–it–like, it's unfortunate that the member continues to put misinformation on– and I'm telling the member, I am close for calling him out on disinformation, because he's refusing to listen.

1992 LEGISLATIVE ASSEMBLY OF MANITOBA May 13, 2022 I'm listening to him, and I'm answering his questions. I am explaining the ad ditional monies that are –been allocated and given directly to school divisions to help keep the lights on. I'm not sure if he doesn't understand the opera - tional dollars versus the capital costs. I a dded the capital costs in there –well, what do you think keeps the lights on? Capital costs. The maintenance costs, that's the additional $260 million we have provided to school divisions over the last two years. And that's each year, so that's $520 million, Mr. Chair.

Holy smokes, we're going to go for a little bit on this because there's –again, the member is totally working on a two years ago and– but what I want to applaud the member is the fact that he did say that funding to schools had gone up. He di d say that. Funding to schools had gone up. He said it. Now, we have also, in addition to that, due to var- ious wage pressures, cost pressures, just like he men- tioned, fuel bills are up, right –not only in Manitoba, across Canada–continue to go up. Rate of inflation, it's a tough go for everybody. So I don't want him thinking that this is only affecting him.

This is affecting our students. It's affecting our families. COVID affected our families, our students, absolutely everybody involved, not only in M anitoba, though, not only in Canada, but across this whole great country of ours, Mr. Chair. We have given, again, $80 million in ad ditional funding this past January for the 2020- 21–no, '21-22 school year. We've at –then given an addi tional $77 million–that's ad ditional money –in the '22 -23 year, which is coming up. All that funding was given, announced the end of February.

And he knows that we are working–and this is probably what's bugging him –is that we're actually working with school boards and trustees and school leadership to have these con versations about the dif - ferent challenges. The only one that is not accepting the fact –ones, I'll say, the ones, plural –that is not accepting the fact that we've gone through a pandemic is the member opposite and his NDP team. I'm asking the member to stop being so political and actually see what's in front of him. He's looking at the FRAME report from two years ago, which he admitted, funding went up.

Take some time; google, over the weekend, the news releases that we have done in regards to ad di- tional funding to school divisions for education to help us through the pandemic–over 250 million addi- tional dollars allocated to help with that, Mr. Chair. I look forward to his next question. Mr. Altomare: There are a number–and I've said this to the minister. The very fact that base funding is only increasing 1.34 per cent has real-world consequences at the school level.

The minister needs to understand that the prov - incial con tribution, as cle arly indicated by the FRAME report, has been 'din' decline since 2015-16. He cannot dispute that, Mr. Chair. And it has, as I mentioned earlier, real -world conse quences at the school level and to kids in the system. * (11:10) One of the largest pieces, here, is we needed to see a plan, post-pandemic, that addresses clinical sup- port in schools.

The member also knows–or, sorry, the minister would know that clinical services have been greatly disrupted these past 26 months, and now there's an opportunity to ensure that clinical services get delivered to the kids that need the levels of supports. In 2018, some of the wait times for psych assess- ments were at six to eight months; those wait times now have increased to close to 20 months. Speech- language supports, as the minister knows, have also been in higher demand; reading recovery, higher demand; reading tutor programs, higher demand.

These are the challenges that are facing Manitoba students coming out of the pandemic. And what they need is a provincial government that's a willing part- ner to address these needs, Mr. Chair. So, I would like to ask the minister, what are the plans to ensure that clinical supports are being sup- ported by the Department of Education to ensure that they get to the kids that need them? Mr. Ewasko: Again, I appre ciate the member's question.

And basically, again, much like other things that are going on lately, it just shows that we need to–in addition to how much col laboration and work we're doing within the sector and our education partners, it also just shows that we need to do a better job of high- lighting the infor mation out there, because the member, even in his role as Education –I'm going to say critic, because I'm sensing the tone that he really doesn't like my old tag line of Education advocate, because he refuses to put some of the facts on the record, but that's okay.

May 13, 2022 LEGISLATIVE ASSEMBLY OF MANITOBA 1993 I sort of know where he's coming from. He's fol - lowing, you know, some of his leader's self -support- ive talking points. I was hoping to have a little bit more of a collaborative question and answers, and I'm going to continue to go down that path of just keeping it high level and, you know, making sure that we're talking about the facts and what is happening within our school system.

So, when we–and again, I appreciate him putting on the record that funding has gone up in Education, and he hasn't quite given the full accolades of the total amount that it's gone up, but that's okay; he'll get there once he gets himself some of the factual infor mation or gets his staff to pull up some factual infor mation for him.

So, a lot of this money that is given, is given– sometimes it's outside that funding model, and the reason for that is because of the col laborative ap - proach not only our gov ernment but the de partment and I have embarked on, actually having conver sa- tions with the front lines, with our school boards, with our trustees, with our super intendents, with teachers, educational assistants. He fails to remember that we have multiple connections all across this great pro - vince of ours that know both of us. Worked in the –I worked in the student services realm for quite some time.

I worked in it from the early years to the high school. I appreciate he's coming to us from the early years standpoint and the adminis- trative standpoint, and that's why I really feel that the– from him coming from the adminis tration side, he should know some of this.

So, in regards to student supports and special needs funding, we have actually given an addi tional $5 million last year, an ad ditional $7 million this coming year, which–I'm just going to give him the percentage, because I know he likes percentages–is an increase of 8.2 per cent over the last two years, in addition to $80 million and $77 million. So, $80 million for this current year that's coming soon to completion at the end of June; $77 million, which is going to start in September, which has already been allocated –been given outside of the funding model. * (11:20) Why is that?

Because the former gov ernment didn't do anything with the funding model, even though administrators like himself stood up and said, we have to do some thing with this funding model, why is the government not listening? That's what they said to the NDP. Well, sir, we're stepping up. We're doing it. We're taking a look at it. We're changing it. And the reason why we're giving all those dollars outside that funding model is, why? It's so that those funding dollars–mil- lions and millions and millions–can go to specifically where it's needed. How do we know where it's specifically needed?

Communication with the sectors and con sultations with the sectors –that is with all of our edu cation partners. That's how we know where those dollars and cents are going and have to go, and that's why we're committed to over $327 million –17.2 per cent in - crease–over the last two years. Mr. Altomare: We do know that –and this has been established–that the FRAME docu ments are reall y important. We do know that the latest FRAME docu- ment that I was referring was released in May of 2021. I would like to ask the minister, can we expect the newest FRAME to be released shortly, since it is May of 2022? Mr.

Ewasko: Yes, but in addition to that, Mr. Chair– because I ran out of time on my previous answer –so, yes, the member asked an answered question. Yes, yes, yes, the next FRAME report is due out shortly. The member asks questions about the fact on, you know, enhancing supports, working with our school clinicians. I know he has first-hand knowledge work- ing with our school supports and clinicians throughout his school and school division, as did I –as do I –still talk to many of them. I don't think he's giving quite the credit where credit is due as well.

So, in addition to our educators, our school staff, our administrators, our senior admin, our trustees, our school boards –they've had to be really flexible and nimble over the last couple years, and I think that they've all done that. And I would not exclude our school clinicians on that as well, whether it's social workers, speech and language pathologists, psychologists, school division psychologists–I mean, they've had to be nimble as well.

They've had to adapt to this hybrid wa y of doing things, as far as assessments and working with stu- dents and because they all–like, I mentioned the other day in one of the speeches, we talked about a calling. Because they've had a calling to this great profession, working with students, and s o they're going to do

1994 LEGISLATIVE ASSEMBLY OF MANITOBA May 13, 2022 everything within their power to be able to make some of these changes and adapt to various things. You know, we've launched also a mental health and well-being strategy with targeting–targeted fund- ing to make sure that we're enha ncing the resources, tools and supports that are required, but not only by staff, but for students. The strategy's going to continue next year; that's an additional $5 million.

And, again, just to put an exclamation mark on this, that's over and above that funding model that the member continues to go to and continues to ignore the fact of all the additional dollars and cents that go out there, Mr. Chair. Also, within that–he might have heard this, you know, in the last year or so–but the Teachers' Idea Fund, we're specifically asking teachers–and I ask him to maybe, you know, put the partisan stuff aside and reach out to some of his former colleagues–I know he talks to them, I know I talk to mine. Put the ideas in. What–because there's no monopoly of great ideas.

I know that the NDP think that they have the monopoly on good ideas, and if that's the case we wouldn't have to fix all those messes that we inherited in 2016, Mr. Chair. But with that, I want him to encourage teachers and people within the sector, with our partners within education to put in their ideas in regards to the dedi - cation to mental health and wellness, because we have embraced that –of the col laborative approach, the listening approach, the doors -are-always-open ap- proach, to coming in and have those conversations.

I do know –I did want to put for my last few seconds here before the next question, Mr. Speaker – or, Mr. Chair, is that the River East Transcona – because that's where he used to teach–over the last two years, the River East Transcona School Division has received a 12.2 per cent–that's a $12.3- million in - crease in funding. This figure does not include addi - tional support for COVID-19 costs. And, as the member knows, school divisions, school boards take these dollars. They've got priorities and they put those dollars where th

Document details

Collection	Manitoba — Debates (Hansard)
Citation	42-4-48c
Type	hansard
Volume / chapter	42nd 4th hansardpdf 48c.pdf
Language	en
Format	pdf
Source	PROVINCIAL
Identifier	328563059d0001f917fe778367a9ad8d56b63f5f

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