Interview Brian Kenny - Jack Carr

EXCERPT / EXTRAIT
Daily Sitting 60 / Jour de séance 60
June 12, 2009 Not finalized / Non finalisé le 12 juin 2009
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046 13:30
Debate on Bill 35
Hon. Mr. Kenny, after Bill 35, An Act to Amend the Nursing Homes Act, had been presented:

The bill to amend the Nursing Homes Act . . .
(Interjection.)

Hon. Mr. Kenny: Sorry. Can I speak from a seat other than my own?
Hon. Members: Agreed.

Hon. Mr. Kenny: I am pleased to present for second reading a bill to amend the Nursing HomesAct. The purpose of this proposed amendment is two-fold, and both items are just housekeeping matters.

First, we are seeking to incorporate the existing Standard Family Contribution Policy into regulations under the Act, but there is no change to the policy itself.

The policy is currently not included in legislation. A small change in the regulation-making authority in the Act is necessary to make the policy law and to give the minister the official authority to administer it.

This is the finalization of a process that was begun by the previous government, and it is essentially an update to legislation as it pertains to subsidies to nursing homes.

The Standing Family Contribution Policy sets out the financial assessment process for entering into a residential facility. Both the applicant and their spouse, whether married or common-law, are evaluated based on their ability to financially contribute to the costs of the services.

The amount of the contribution is based on the client’s net income, the couple’s net income, and the type of service required, and whether there is a spouse or dependents living at home. New Brunswickers will see no difference when they apply for services at a residential facility as a result of this amendment.

The policy simply becomes more transparent as part of the legislation.
Specifically, the proposed amendment will set in regulation the conditions for eligibility for subsidized care in nursing homes, and it will allow the minister the discretionary authority to waive or modify the family contribution to the cost of the care.

The amendment only reflects the current
application of the Standard Family Contribution to the cost of care. The amendment only reflects the current application of the Standard Family Contribution Policy. It will have no impact on the cost of nursing home care for New Brunswickers.

Also, we are seeking to add pharmacists to the list of occupations within the legislation. This is consistent with our government’s commitment to support the role of pharmacists in prescribing certain drugs, to increase patient access to primary health care.

This amendment will ensure that the Nursing Homes Act is consistent with Bill 60, An Act to Amend the Pharmacy Act, which came into force in October, 2008. Amending the Nursing Homes Act in this way will ensure that the enhancements to the role of pharmacists are included within the legal framework of nursing homes operating in New Brunswick.

Pharmacists will be added to the list of persons authorized to dispose of unused medication in the event that a nursing home resident is discharged or transferred, and pharmacists’ notes and orders will be added to the record-keeping duties of the nursing home administration.

Nursing home services will be improved by this amendment. More information on the health care of residents will be available and accessible to medical staff. If there are any questions, I am willing to take them.

Mr. Jack Carr: I will be fairly brief. I will probably take 20 minutes or so. I have no concerns at all about the second reason for updating this Act, putting pharmacists in-line with the Pharmacy Act.

I think that is a good move. The pharmacists, of course, think that this is good as well. I would like to ask some questions about the Standard Family Contribution Policy and what this Act does in relation to it.

First of all, minister, will you have the authority to waive and make exceptions to the Standard Family Contribution Policy after this Act is passed?

Hon. Mr. Kenny: The regulations and discretion are the same as those in the policy. Nothing has changed.

Mr. Jack Carr: Right now, in the policy, the minister has the discretion to waive or modify the family contribution to the cost of care. This bill actually puts the policy and the Act in-line.

My question is this. Do you personally, as Minister of State for Seniors, have the authority to waive or modify the family contribution to the cost of care, or does only the Minister of Social Development have that authority?

Hon. Mr. Kenny: The Minister of Social Development is in-line with this Act would be able to make any ministerial decisions.

Mr. Jack Carr: I have been an MLA for six months. I had a briefing by staff when I first became the member for New Maryland-Sunbury West. They went through the process by which a resident could, if not pleased with a ruling, plead a case to the minister. That is what this entails.

The minister already has that discretion, but this aligns the discretionary authority to waive or modify the family contribution to the cost of care with the Act. You mentioned that the Minister of Social Development has that authority.
What authority do you have?

Hon. Mr. Kenny: As the Minister of State for Seniors, my role is to be able to bring information from seniors, because we realize the senior population in New Brunswick and throughout Canada is growing. Demographics are changing. Because seniors are such an important part of our policy,I also have the authority to be able to review policy.

Ultimately, it is the Minister of Social Development who will make the final decisions on policy changes.

Mr. Jack Carr: That is what I have been saying all along. As the Seniors Critic, I have been saying that your role is essentially stakeholder relations. The minister ultimately has the authority. That is what I have been saying is my concern all along.

You are doing a fantastic job of meeting seniors and traveling the province. People in every seniors’ group to whom I talk say: We met with the minister of seniors two months ago, last month, or whatever the case may be.

However, my concern is that you are doing the consulting and the stakeholder relations, but you do not have the authority. This is a good example here today. I am still somewhat wondering why you are taking the questions when this bill does not really pertain to you.

It says that this bill is to be in line with the policy,which says the minister has the discretionary authority to waive or modify the family contribution to the cost of care. However, you do not have the authority to do that. It is the Minister of Social Development who has that authority. Unfortunately, that minister should be the one answering the questions.

Maybe you can answer some questions on the Standard Family Contribution Policy, when it comes to veterans living in nursing homes. How many veterans are currently living in provincial nursing homes?
Hon.

Mr. Kenny: The regional offices keep statistics and information on the demographics and on the types of people who are living in nursing facilities. What I will have to do is take this question under advisement and get the exact numbers for you. I will report back to you with the exact numbers. I will give you a copy so that you know exactly how many veterans are in nursing home facilities.

Mr. Jack Carr: Thank you. Could you give me a copy of the review that was undertaken as well? The government recently completed and announced it. 049 13:45

Hon. Mr. Kenny: No actual written review was done. It was in-house, with a number of staff members and officials dealing directly with Veterans Affairs Canada and with the regional offices to be able to get information on that. If you are looking for an actual document or review, there is probably no such thing available. Rather, it would be dialogue between the provincial department, Veterans Affairs Canada, and the regional offices.

Mr. Jack Carr: Again, this is an issue that I raised in the Legislature earlier this week.

I am concerned, because—correct me if I am wrong—this ties into the Standard Family Contribution Policy. The government now claws back the disability pensions of veterans living in nursing homes, who cannot prove that their disability is related to their time in service.

Can you clarify if that is correct? Right now, the government does not claw back or will not claw back the disability pension that veterans receive if they were inflicted with their disability during the time that they were in service.

Right now, the government is pursuing and will be clawing back the disability pension that veterans receive, if they cannot prove that their disability is related to their time in service.

Hon. Mr. Kenny: What we did during our review and in our consultation between the department in Fredericton and Veterans Affairs Canada was that we followed the same regulations that Veterans Affairs Canada does when it does its assessment of any veteran who is in a facility that is operated by Veterans Affairs Canada.

Mr. Jack Carr: What you are saying is that, federally, Veterans Affairs Canada does the exact same thing. It claws back the disability pension of residents who live in the nursing homes of Veterans Affairs Canada.

It will claw that back if veterans cannot prove that their disability is related to their time in service. This is what Veterans Affairs Canada does right now. Is this what you are aligning your policy with?

Hon. Mr. Kenny: That is accurate. That is correct.

Mr. Jack Carr: Through which process did you come to that conclusion? You said that there was a review. You have known for months prior to this policy change.

The government would have known that this is what Veterans Affairs Canada does. How extensive were those consultations?

What did you personally do to consult seniors and the Minister of Veterans Affairs?

Hon. Mr. Kenny: I had a chance to speak personally with the Minister of Veterans Affairs, Hon.Greg Thompson, and his staff about this issue. From there, I instructed the regional department to make sure that it had open dialogue with Veterans Affairs Canada. Numerous phone calls were made back and forth, to find out the exact policy that was being set forth by Veterans Affairs Canada and to make sure that we were in line with it.

Mr. Jack Carr: When and where did you speak with Greg Thompson and his staff?
050 13:50

Hon. Mr. Kenny: I believe it was in Bathurst, when we were opening the wing in conjunction with the minister. I made a comment to him that our department was looking into this. This would have been a few months ago in Bathurst, at the Robert L. Knowles Veterans

It was the expansion that the federal government put into it. It was a proud day for Bathurst and for veterans.

Mr. Jack Carr: This was not a specific meeting that you had requested with Mr. Thompson and his staff.

This was a different event. You were there, as was the Minister of Veterans Affairs, but this was not a specific meeting that you or the minister had requested.

This would have been a reception,at the announcement. In passing, you mentioned to Mr. Thompson that you were reviewing this.Was that the extent of the discussion?

Hon. Mr. Kenny: Sometimes, in the world of politics, you seize the opportunity. We knew that our department was going to be looking into this. It just happened that the times and stars lined up and that he was there. I had a chance to meet with him for a few minutes.

It was unplanned, but it worked out well. Basically, I just let him know that we were reviewing this policy and that the department would do the follow-up with Veterans Affairs Canada.

Mr. Jack Carr: Just to be clear, when you mentioned in the media that you were in discussions with the minister and his staff, that was the extent of it on your personal level.

Then, the staff of the two departments discussed this issue. To what extent did the staff of the provincial and federal departments meet on this issue?

Hon. Mr. Kenny: The department has a very good dialogue with Veterans Affairs Canada, and a number of phone calls were made back and forth over a period of time.

As for being able to give you an exact period of time and the number of phone calls, I just know that the dialogue was open and that I asked for updates to me, to make sure that the communication was open. They worked very well together.

Mr. Jack Carr: Just to be clear, this would be one of those discretionary policy changes. Actually, I should rephrase that. This would not really be considered a discretionary type of change.

This would be a change that you incorporated in the Standard Family Contribution Policy. What does it take to change that policy? Is that done by all of Cabinet, or can the minister herself do that? 051 13:55

Hon. Mr. Kenny: This is one of the reasons that we have the amendment to the Nursing Homes Act. We want to be able to have that authority, and here is a good example. This was done internally, within the department, and basically at my request to the department.

We went forward with this,and changes were made within the department. It was for a good cause.

Mr. Jack Carr: Can you explain what that good cause would be? It is my understanding that, previously, all veterans living under the long-term care program did not have to claim their disability pensions.

What you have done is limit that to only veterans who have a disability pension that is related to their time in service. Could you clarify what this good cause was?

Hon. Mr. Kenny: This is actually an improvement to the policy. It will allow us to exempt the disability pension for a veteran who is under the Veterans Affairs policy. Therefore, this is actually an improvement to the policy for veterans.

Mr. Jack Carr: Maybe I need more clarification.

You are telling me that, previous to this, all disability pensions received by veterans who were in long-term care were clawed back. However, it is my understanding that the government—and maybe the previous government intended to do this—was not going to claw back those pensions for all veterans living under the long-term care program.

I would appreciate it if you could clarify this for me and briefly give me a little bit of background.

Tell me how we got to where we are today. What was the policy in 2005? We know about the court case involving a member of Veronica Ratchford’s family.

Also, what did the government do because of that? What was the policy concerning veterans with disabilities?

Most recently, when did the policy that we are talking about right now—exempting those veterans with disability pensions related to their time in service—come into effect?
052 14:00

Hon. Mr. Kenny: The member is right when he says that, in 2005, the amendments referring to the treatment with a spouse living at home . . . Can you hear? In a specific case where a veteran was living in his home and had a spouse living in a nursing home, the disability pension, at that time, was used in the calculation formula.

At that time, it was changed to alleviate that from happening where it was exempt. That was a step forward. Today, we are talking about a veteran who would be living
in a facility and have an injury related to his work, a disability, and that is also exempt in a nursing home.

Mr. Jack Carr: Did you mean nursing or long-term care? Long-term care. Thank you. I would like to encourage the minister to go even further. I know that we get confused sometimes that they will say: Go further and go more.

It is good that you are making this step forward to include those veterans with a disability pension if they can prove that their disability is related to their time in service.

What you could do in your stakeholder relations, and what I will do, is encourage all
veterans in long-term care who feel that their disability is related to their time in service to write to Veterans Affairs Canada and get that process started in case they do need to prove it.

One could argue that disabilities could be related to their time in service. Years later, they may end up with a back injury or a knee injury that could be connected to their time in the service.

Now, the onus is on the family, on the veteran, to have to prove that their disability is related to their time in service.

I think that is wrong. I think you should allow all veterans in long-term care to keep their disability pension and not claw it back, regardless of whether or not they can prove that their disability is related to their time in service.

Unless you want to comment on what I just said, I will go back to my questions. You told me that you would be getting back to me.

I will probably follow up with you, and possibly with your deputy minister, to have a briefing on this because you had said that a review had taken place internally.

I already asked one question, and you said you would get back to me. These questions deal mostly with statistics. How many veterans live in New Brunswick now?

How many veterans are under long-term care in the province? Can you break that down into nursing homes, special care homes, and home support? How many veterans are in long-term care with a disability pension?

How many veterans are in long-term care with a disability pension that is related to their time in service? If there are any more questions, I will e-mail them.

I do not expect you to answer those, so I will be getting the transcript and will forward it to you. If you have those numbers, that is great. I wanted to put the questions I have on the record.

Also, I am quite concerned that the government is putting the onus on the families, on the veterans,to prove that their disability is related to their time in service.

I do not think veterans should have to do that. I think veterans should be treated as they are in every other province, except for Newfoundland and New Brunswick.

Maybe the minister can clarify that, but the information I have is that Newfoundland and New Brunswick are the only provinces that claw back the disability pensions of veterans who cannot prove that their disability is related to their time in service.

Can the minister confirm that New Brunswick and Newfoundland are the only provinces that do this? 053 14:05

Hon. Mr. Kenny: What we will do is confirm and get you all the answers to the questions that you have asked.

We will get you some exact figures. It will take some time, because we have to go through Veterans Affairs Canada. Sometimes, it takes a bit of time to get that information back and forth, but we will make sure that we get that information to you.

The first answer would be with regard to the information that you already have, because of the review that was undertaken. You should already have that information, if you had discussions with Veterans

Affairs Canada. All those would be questions that you would probably ask if you were undertaking a review. Second, the next set of answers would be with regard to the updated numbers that you would get by contacting Veterans Affairs Canada.

I would assume that it would not be unrealistic to ask for those numbers by next week, because, as you said, there were extensive discussions
between each department.

I appreciate the goodwill and the work of the staff, as well, by the way, but let’s just be clear that you have the discretionary decision . . .

The Minister of Social Development has the discretionary authority to waive or modify the family contribution to the cost of care.

Even though, right now, the disability pension of veterans is clawed back if they cannot prove that their disability is related to their time in service, under certain circumstances, they could go to your department, to the Department of Social Development, plead their case, and hope that you would be able to waive that.

Hon. Mr. Kenny: The member is correct. The exception would be for an extreme hardship, where the veterans could come to the department and make their case to us.

The department would look at it under extreme hardship, and that case, if the decision was in their favour, would last for 12 months. After 12 months, there would possibly be a review.

Mr. Jack Carr: I want to thank the staff. That concludes the questions that I have. I do not think any other member on this side has any questions. I want to thank the staff for taking of their time. They are always working hard for the people of New Brunswick.

However, I want to mention again that the minister made it clear that it was his final decision, along with the Minister of Social Development, to claw back the disability pensions of our veterans living in nursing homes and in special care homes and also receiving home support.

Those disability pensions are clawed back for those who cannot prove that their disability is related to their time in service. I think that is wrong, Mr. Minister.

However, I congratulate you in moving a small step forward to recognize those veterans’ pensions,if they can prove that the disability is service-related. I know the number, and that is why I am calling on the government to be like every other province in this country and to recognize the disability pensions of those veterans in long-term care.

Do not claw them back. Veterans, right now, do not have to put those pensions on their income tax. Therefore, they should not have to put the pensions toward the Standard Family Contribution Policy.054 14:10

I have one other question that is related to disability. It is with regard the $1000 Disability Supplement. Is that $1000 cheque that they get in October considered as income in the family contribution policy under Social Development?

Hon. Mr. Kenny: That is for any recipient under the social assistance program, and that would not be considered under this. It is not part of their family contribution.

Mr. Jack Carr: Because they are social assistance clients and need to live in a nursing home, they do not have to go through the family contribution policy.

Just for clarification for me, if they are trying to apply to go to a nursing home or special care home, they do not have to consider that as income.

Therefore, that question would not really apply in this case, but it will be something that I will be following up on with the minister to see if she is actually considering that as income in other contribution processes.

I have heard that it is something that the minister is considering including as income, but I hope that she is not.

On that note, thank you very much. Again, I want to thank the staff and the two ministers for being here today. As critic for seniors and for persons with disabilities, I will continue to push this issue so that, one day, a government will consider the disability pensions that veterans have when they are in long-term care, and not claw them back. That is exactly what this government is doing.
On that, thank you, and have a good weekend.

Hon. Mr. Kenny: With all due respect, you are a good critic, and I know that you do your research and homework and you do a good job on that.

However, we have made record investments. We have done so much as a government since 2006, when we got here with our Charter for Change, for the respect and dignity of our seniors and our veterans in this province.

I just want to let you know, for the record, that you folks on the other side were here for seven and a half years, and you had the chance to do some work. I am very proud of our record.

With that said, I am very proud of the record we have right now. Yes, we can do more in the future, and we plan to do more in the future.

Have a good weekend also.

Mr. Jack Carr: I want to end this on a high note and compliment the staff and the ministers for their goodwill and their openness. I must say, however, that I cannot let that go.

When the government is clawing back the disability pensions of our veterans living in nursing homes, special care homes, and in long-term care, it is my obligation to raise that as the official opposition.

It is wrong that this minister is doing that. When the government is raising the monthly nursing home fees by $400—$4 800 a year—that is wrong as well.

On this side, as critic for seniors and persons with disabilities, I will continue to push those issues. On that note, have a good weekend.

Hon. Mr. Kenny: I just want to wish the opposition a nice weekend. Hopefully, it will be sunny, and we will have a nice, fine weekend.

(Bill 35, An Act to Amend the Nursing Homes Act, was agreed to as presented.)
Madam Chairperson: I will now call Mr. Deputy Speaker.

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(Mr. Deputy Speaker resumed the chair when the committee rose.)