Category: Doug Graham Letters

Government had good reasons for decision on YCOD funding

Doug Graham, MLA for Porter Creek North

Letter to the Editor – Whitehorse Star, as submitted on Friday, March 6th, 2015
by Doug Graham, Minister of Education

I read with interest your editorial of February 20, 2015 regarding the contract for funding the provision of employment services for Yukoners with disabilities with the Yukon Council on DisABILITY (YCOD).

In your editorial, you have overlooked the fact that the ‘modest’ funding of $248,000 per year was actually a contract with YCOD to provide employment services for persons with disabilities, specifically to assist them in finding, gaining and maintaining employment. The funding is part of the Canada-Yukon Labour Market Development Agreement, which provided approximately $3.5 million for 2013/14 to support YCOD and other Employment Assistance Providers such as Employment Central, l’AFY, YUWIN, Klondike Outreach and Watson Lake Outreach, and programs such as Self-Employment, Skills Development and Apprenticeship Seats, none of which have failed to meet the terms of their agreements to provide services to persons with disabilities.

You have also not acknowledged the fact that the Government of Yukon has a responsibility to provide justification to Canada, in the form of statistical and other information, as part of the transfer of this funding. It is very difficult to meet this requirement if the information is not provided by the non-governmental organization (NGO). Yukon government’s “strict adherence to program formulas”, as you put it, is how this funding is justified, and if the requirement is ignored as you suggest, the funding for other, very responsible NGOs may be put in jeopardy.

Government also has a responsibility to ensure that taxpayers’ dollars are spent appropriately. In the same manner that government is audited by the Auditor General, we must also ensure that the funding Yukon government provides to other organizations is used to deliver the services that were intended. In this case, my department felt that the employment assistance services were not being provided effectively by YCOD, and several of the key milestone tasks were not being performed as required by our agreement. Advanced Education staff met with the YCOD Board on a number of occasions over the past year in an effort to address the performance issues. Although some progress was being made, the decision to begin recruiting an organization to deliver employment services to persons with disabilities was made when the application submitted by YCOD on January 30, 2015 did not appear to address any of the issues identified by the department and discussed with the YCOD board in previous meetings.

The lack of fact-checking on the NGO scene in the territory is also evident in your statement that “the council is one of an extremely limited number of sources of living assistance, mediation and job-search support for Yukoners with disabilities”. In fact, there are a very large number of NGOs that provide support, living accommodations, advocacy and employment services to persons with a wide variety of disabilities. Recently, I had the pleasure of speaking at the opening of the Yukon Association for Community Living’s “Ready, Willing and Able” presentation to Yukon employers on the benefits of hiring persons with disabilities. It was an excellent presentation, yet I noted the lack of news media in attendance.

Thanks for your friendly advice on how to run the territory; perhaps I can return the favour. In response to your “friendly” advice for me, I would like to address your claim that government failed to respond on this issue. Don’t expect hurried telephone responses to all of your inquiries, as I like to be sure of the facts and I refuse to be rushed into providing an answer that I may later regret because I did not do my homework before giving an interview. I also don’t ask my department staff to provide answers to the news media when I am responsible for making the final decision. So, please understand that answers will be forthcoming on my schedule, not yours. On one issue though, I do agree – the public has a right to know all of the facts, and I’d suggest you have neglected to do so by failing to update your commentary when new information was provided to you. I draw your attention to the information that YCOD sent you after your published editorial.

My government is committed to assisting persons with disabilities, not only in seeking employment but also in assisting them to participate in Yukon society in a full and meaningful manner. The decision to tender the contract for employment services for persons with disabilities was not done to penalize YCOD; it was done to ensure that these Yukoners are receiving the best possible services that we can provide.

Yukon government committed to education

Doug Graham, MLA for Porter Creek North

As submitted to the Whitehorse Star on Friday, February 6th, 2015
by Doug Graham, Minister of Education

On New Year’s Day, former Education Minister Elaine Taylor had the distinct pleasure of awarding Governor General’s Academic Medals to top achieving Yukon students. It was an honour for her to recognize these young people for their outstanding academic performance, and they should be proud of their remarkable achievements.

Education is a top priority for this government and we recognize the importance of student financial assistance in helping Yukoners to further their life-long learning journey. We are committed to providing access to funding that makes it more affordable for Yukon students to pursue post-secondary studies. We provided $4.3 million in annual funding to approximately 980 Yukon post-secondary students during the 2013/2014 academic year. This helps give Yukon students a significant financial advantage as they pursue higher education.

Last December, my colleague, Watson Lake MLA Patti McLeod tabled a motion in the Yukon Legislative Assembly, urging the Government of Yukon to seek public input on changes to the Students Financial Assistance Act for fair, equitable and fiscally- responsible methods to enhance access to financial assistance for current and future Yukon post-secondary students. Members of the house debated the motion and it passed with unanimous consent.

We are therefore going forward asking Yukoners how to best update the Students Financial Assistance Act. The input of students, their families, and other key stakeholders will help us ensure that our financial assistance program continues to be accessible and to be effectively administered.

In addition to the upcoming consultation on the Students Financial Assistance Act, Yukon students and families may also be interested in learning about some important changes we have made to the Yukon Excellence Award Program.

The Award Program will be broadened to include more types of courses and consider course performance rather than focus strictly on final exams. Previously, the Excellence Awards focused on exam performance in language arts, mathematics, social studies and science. Under the new rules, scholastic performance in art, music, shop, home economics and outdoor education will also be considered.
Awards in the amount of $300 for each subject can be earned by students in Grades 10 to 12 who achieve a final overall mark of 80 per cent or higher in up to five mandatory and five elective courses. This will apply to a maximum of four Grade 10 courses, three Grade 11 courses and three Grade 12 courses, for a maximum total amount of $3000.

Why are these changes needed? We want to encourage more students to go into the trades and to explore all available post-secondary options. The Yukon Excellence Awards encourage Yukon secondary students to do well in their coursework and earn financial support for their post-secondary education or training. They promote Yukon Education’s goal for success for each learner and help create an inclusive, adaptable and productive workforce that meets the needs of Yukon employers.

Post-secondary students have a significant advantage in that they can also apply for the Yukon Grant. Currently, between 750 and 800 students per year receive this grant. Grant recipients attending college in the territory receive approximately $3700 per year, with those attending institutions outside the territory receiving additional funding for travel expenses.

Information about student financial assistance and academic merit awards can be found on our departmental website at http://www.education.gov.yk.ca.

I would like to reiterate the importance of lifelong learning. There is never a bad time to improve your academic credentials or make yourself more employable. This government is deeply committed to encouraging lifelong learning and enhancing students’ access to post-secondary education opportunities.

Getting the Facts on a new Continuing Care Facility

Doug Graham, MLA for Porter Creek North

As submitted to the Whitehorse Star on Friday, April 11th, 2014
by Doug Graham, Minister of Health & Social Services

Your government has set aside $6.9 million in the 2014-15 territorial budget for design work on a new continuing care facility for Yukoners. As Minister of Health and Social Services, I would like to provide you with the facts about our planned facility and the reasons why continuing care is a priority for this government.

Like all other areas of Canada, Yukon has a growing population of seniors. It is critical that planning is done now to ensure that services are in place to meet this growing demand. Other related health care issues include dementia, respite needs, mental health diagnosis and hospice palliative care.

Our overall approach is to support seniors in living in their homes as long as possible, while also ensuring we have facilities in place to provide more complex care when needed, at a cost that we can afford.

Some things for you to consider:

  • Yukon has the highest ratio of individuals over 85 who are living alone.
  • National trends show that the greatest growth in the percentage of seniors in the population will be in the North.
  • Across Canada there is a rapidly growing need for dementia care.

Yukon currently has one of the most comprehensive bundles of no cost home care programming in Canada, offering home support, personal care and professional care services (through nursing, therapies and social workers). Although home care is very effective in keeping people safely in their own homes longer, both in Whitehorse and in rural Yukon communities, it is not a substitute for continuing care for those who require a significant level of support or specialized services. Our data shows that 40 % of home care clients are at high risk for institutionalization, and 14 % have no local caregiver at all.

When communities are not able to support individuals, and when continuing care beds are not available, people often end up in hospital. This is a problem for several reasons:

  • They don’t receive the specialized care and services that they require (this is especially an issue for dementia care clients).
  • Hospital beds are extremely expensive, and therefore this is not a sustainable practice.
  • Beds filled with clients waiting for continuing care have an impact on the operation of a hospital. For example, those beds will not be available for elective surgeries.

The waitlist for long term care in Yukon currently has 41 clients, and the list grows each month. The average wait is four months, with a range of anywhere from one to 15 months. Last year, a needs analysis was completed which identified significant need for additional bed capacity in continuing care over the next 20 years. Conservative estimates project the need by 2021, based on current utilization patterns, will be 320 to 380 beds, and by 2035, it will have grown to 430 to 550 beds.

This is why we are proceeding with planning a new facility to provide up to 150 beds in the early stages of the project, with infrastructure to support 300 beds in total, which will be added on in phases. We anticipate that design work will occur throughout 2014 and 2015, with construction from 2015 to 2017.

We want to ensure that Yukoners have timely access to the best, safest, most appropriate care possible. Planning for this new facility will ensure we can support the growing number of seniors who will require complex care or specialized dementia care. Ensuring there is a strong First Nations cultural component will be an integral part of the planning.

The new facility will be designed to best practise standards of smaller congregate living units or neighbourhoods that are warm, home-like and easy for residents to navigate and socialize in. We are reviewing best practices and best industry intelligence to ensure we meet clients’ needs.

Since our announcement was made, there has been some public comment concerning centralization of continuing care in Whitehorse. The government considers it a priority to help ensure seniors can remain in their home communities as long as possible, which is why we have built new seniors’ residences in Haines Junction, Watson Lake, Teslin and Faro over the last few years, with plans to replace MacDonald Lodge in Dawson City and funding allocated for a seniors’ residence in Mayo. However, when a community is no longer able to support an individual with complex, specialized care requirements, the advantage of a larger facility is that you can group individuals with similar care requirements and needs, as the staffing, programming and supports required are very different. To have specialized care in each and every Yukon community is not affordable, nor sustainable.

Significant assessment and planning has gone into the government’s decision to proceed with this project. Long-term care is an issue that affects every Yukoner. It is important that we take steps now to ensure high quality care in the future for the benefit of all Yukoners.

If you have ever been faced with the challenge of caring for loved ones who are aging, or who have dementia or other long-term health issues, you will agree that Yukon has some of the best care available, thanks to our extraordinary staff and volunteers. Our goal is to continue to provide a continuum of services to meet care needs, from supports for aging in place, to a robust home care program, to continuing care beds, while ensuring our health care workers have the best facilities and programming to continue their fine work.

Success of Home Care a Testament to Collaborative Care

Doug Graham, MLA for Porter Creek North

As submitted to the Whitehorse Star on Friday, January 10th, 2014
by Doug Graham, Minister of Health & Social Services

The term “collaborative care” has been in the news recently, as a model of care we are adopting across Yukon’s health care system. As we move in this direction, it’s useful to take a look at examples we already have of how a collaborative care approach has helped us deliver better, more cost-effective service to Yukoners. Home care in Yukon is one such example.

The term “collaborative care” is somewhat self-explanatory. It refers to a team approach that involves a variety of trained medical and other professionals, all working together, or collaborating, to deliver the service that individuals need. The emphasis is on ensuring each professional involved is able to work to the full scope of their training and use all their skills, abilities and knowledge to deliver service. The goal is to ensure Yukoners receive the best possible health care services in a timely, responsive and cost-effective way.

The Yukon Home Care Program provides client-focussed health services in the home, improves quality of life and supports Yukoners in living safely and independently in their own homes, which is where they want to be. The program offers a “bundle” of services, including professional services such as nursing, social work and therapies; personal care such as assistance with dressing, bathing, feeding, transfers and mobility assistance; and home-making, with a focus on safety and sanitation. Yukon’s level of home care service is considered to be one of the most comprehensive bundles available in the country.

Yukon does face challenges in the delivery of home care. For example, 15 percent of home care clients in Yukon have no family caregivers available to them, compared to the national average of 2 to 3 percent without a caregiver. In recognition of this and other challenges, the Yukon Home Care Program works to integrate and link its services with community partners, such as First Nation programs, community nursing, hospital services, chronic disease management teams, and primary care physicians.

The program also uses technology in the provision of care – laptop computers and telehealth systems link clients, care providers and professional staff in communities, Whitehorse and larger centres in southern Canada. We have also hired a new Health Promotion and Prevention care coordinator, who works with clients to help them pro-actively manage their health. In addition, we provide respite services that give caregivers the breaks they need, and which can prevent or delay clients from entering the acute care system.

In addition to the benefits to individuals, our approach to home care also provides a cost benefit to government and ultimately to taxpayers – the cost for an individual to receive home care is $38/day, compared to long-term care, which costs up to $400/day and hospital care, which costs $2200/day.

We know that the percentage of Yukoners who are 65 or older will nearly double by 2021 and triple by 2030. This is why it’s so important that we keep our focus on collaborative home care that meets the individual’s needs in a fiscally-responsible way. This approach to home care will help us keep our clients happier and healthier and in their own homes.

And, as we look beyond home care to a broad range of health care needs, the collaborative approach shows much promise as a way to serve all Yukoners better.

Government works to recruit doctors and provide best health care possible

Doug Graham, MLA for Porter Creek North

As submitted to the Whitehorse Star and Yukon News on Friday, October 18th, 2013
by Doug Graham, Minister of Health & Social Services

When the Doctorless Patient Registry closed at midnight on September 30th, 1830 individuals had registered themselves as being without a family physician. This number will likely be adjusted in the coming weeks, as we know that some on the list have since found a doctor and others have mailed in registrations that we have yet to receive.

Many on the list chose to provide contact information, in case government was able to match them with physicians.

However, the registry was never intended as a matching service or to allow for the active management that the Yukon Medical Association (YMA) has suggested.

The registry was created to provide government with a snapshot of the situation, to help determine the number of people without a doctor and to see if the number provided by the YMA (8000 doctor-less patients) was accurate.

The confusion over the purpose of the registry was further aggravated when the president of the YMA, Dr. Rao Tadepalli, recently encouraged people to get on the registry so they could get a physician. He added that the YMA did not support the closure of the registry but rather thought it should be maintained permanently as a means of pairing patients with physicians.

Attaching patients to physicians is not the responsibility of government. Our responsibility is to ensure that citizens have access to health care that is appropriate, timely and effective. The hard data from the temporary registry will help us determine how many physicians and other health care providers Yukon needs and assist us in looking for new and innovative ways of providing health care services, aside from independent physician businesses.

The YMA has said four physicians are coming early in the new year. Through our work with the physician recruitment officer and with Yukon physicians, we are aware of additional physicians who will come north over the next year. This physician complement should be adequate to serve the needs of Yukon residents, both at present and well into the future. That said, we know that other physicians will retire or leave Yukon and we will include that factor in our overall recruitment planning.

Government will welcome all new doctors to the territory and offer them, as in the past, a free ad to let citizens know they are here. It is the patients’ responsibility to follow up, and the physicians’ responsibility to take on new patients.

In the midst of the government’s ongoing efforts to ensure Yukon has enough doctors, there is an element that most Yukoners will not be aware of, a proposal from YMA that would see government pay physicians thousands of extra dollars for taking on new patients, a proposal we are resisting.

Physicians are self-employed and like all self-employed workers, they can work as much or as little as they choose, either part-time, full-time, or with many extra hours. The government pays the physicians for each service a patient receives. The resulting pay for general practitioners ranges from $140,000 to a current high of $959,000 for the top paid family physician in Whitehorse. The average hovers around the $317,000 mark, with a number who make in excess of $650,000 per annum. These are fee-for-service general practitioners, not specialists such as general surgeons or obstetricians.

Government also provides physicians with funding for continuing medical education, education support, locum support, maternity/paternity benefits, office start-up, office renovation, physician re-location, assistance to new graduates of the College of Family Physicians and the Royal College of Physicians and Surgeons to cover some educational expenses, medical practice insurance, and recruitment and retention bonuses for physicians.

From our perspective, the Yukon government is already doing its share to support physicians. Our responsibility now is to ensure recruitment efforts continue and to examine new service delivery models that will benefit Yukoners, along with the valuable services traditionally provided by physicians.