N.W.T. should consider privatizing long-term care: report

Privatizing long-term care facilities in the Northwest Territories is one "outside the box" option the territorial government should consider when trying to fund the care of the growing seniors population over the next 20 years, according to a report released Monday by the Department of Health and Social Services.

"We need to look at whether there's an interest in either the private sector or the not-for-profit sector in providing the service in the N.W.T.," said Debbie Delancey, the deputy minister of Health and Social Services.

The department estimates that by the year 2034, 11.6 per cent of the territory's population will be aged 70 years or older, resulting in a shortfall of 467 long-term care beds. While 28 new beds are currently under construction — 18 at a new facility in Norman Wells and 10 at the Jimmy Erasmus Seniors Home in Behchoko — no further long-term care facilities are included in the government's capital plans.

"You all know our capital budget is extremely constrained," said Delancey.

"So we have to look outside the box. We have to look at [whether] there are other ways we can acquire that infrastructure."

Provinces are doing it

One such option would be to use some space in the current Stanton Territorial Hospital in Yellowknife as a space for long-term care beds, once the new hospital is built.

But another option cited in Monday's report calls for the department to "undertake research and evaluate the potential to convert existing GNWT owned and operated LTC facilities to a more private sector business model," even if that option comes with "considerable political and labour relations challenges."

The territorial government currently owns and operates facilities in Yellowknife, Fort Smith, Hay River and Fort Simpson.

"Across Canada many other jurisdictions are going to privately-owned facilities," said Perry Heath, the health department's director of infrastructure planning.

"They've seen that they can operate them at a reduced rate [compared to] public systems."

How private facilities would affect the monthly $772 fee currently paid by residents of N.W.T. long-term care facilities would need to be looked at, added Delancey.

Privatization is not the only option cited by the department, however.

"We've had great discussions with Avens in Yellowknife. Avens has land, Avens is interested in a project that might be financed through the traditional government capital planning process or through other more creative ways to leverage other funding," said Delancey.

The department is also looking to the upcoming federal budget, which is expected to include money for seniors housing and home care.

"We don't know what that looks like, but we hope that might include something that would help us," said Delancey.

Addressing disparities in aboriginal/non-aboriginal health

The department is also taking more preventative steps.

"One of the things we're aware of is that there are significant disparities right now between the health status of aboriginal people and non-aboriginal people," said Delancey.

"That affects the age at which somebody might be moving into long-term care."

The report — which was informed by research from the NWT Bureau of Statistics — found higher incidents of kidney disease, chronic disease and hospitalization among aboriginal residents compared to non-aboriginal residents.

At the same time, only 20 per cent of seniors leaving the territory are aboriginal. That overall set of circumstances "becomes an important part of the projection and the formula we use to assume how many people over the age of 70 may need to access a long-term care bed," said Delancey.

She said the department has formed an aboriginal health and community wellness division.

"We're doing research with the University of Alberta to try to understand why aboriginal people do not take [advantage] of cancer screening opportunities at the same rate that non-aboriginals do ... so that we can go in and try to change it."