HANSARD

 

NOVA SCOTIA HOUSE OF ASSEMBLY

 

 

STANDING COMMITTEE

 

ON

 

HEALTH

 

 

Tuesday, January 13, 2026

 

 

COMMITTEE ROOM

 

 

Community Wellness Framework

 

 

 

 

 

 

 

 

 

 

 

Printed and Published by Nova Scotia Hansard Reporting Services

 

 

HEALTH COMMITTEE

Danny MacGillivray (Chair)

Adegoke Fadare (Vice-Chair)

Hon. Susan Corkum-Greek

Ryan Robicheau

Nick Hilton

Lisa Lachance

Rod Wilson

Hon. Iain Rankin

Hon. Derek Mombourquette

 

 

 

In Attendance:

 

Gordon Hebb

Chief Legislative Counsel

 

Robin Dann

Legislative Committee Clerk

 

 

 

WITNESSES

 

Office of Addictions and Mental Health

Kimberly Stewart, Associate Deputy Minister

Francine Vezina, Senior Executive Director

 

Canadian Mental Health Association Halifax-Dartmouth

Margaret Murray, Co-Executive Director, Building Bridges Manager

Bev Cadham, Co-Executive Director, Social Clubs Program Manager

 

Nova Scotia Hospice Palliative Care Association

Tim Guest, Executive Director

 

Mental Health Foundation of Nova Scotia

Starr Cunningham, President & CEO

 

 

 

 

HALIFAX, TUESDAY, JANUARY 13, 2026

 

STANDING COMMITTEE ON HEALTH

 

1:00 P.M.

 

CHAIR

Danny MacGillivray

 

VICE-CHAIR

Adegoke Fadare

 

 

THE CHAIR: Order. I call this meeting to order. This is the Standing Committee on Health. I’m Danny MacGillivray, MLA for Pictou Centre and Chair of this committee. Today we’ll hear from the Office of Addictions and Mental Health, the Canadian Mental Health Association Halifax-Dartmouth, the Nova Scotia Hospice Palliative Care Association, and the Mental Health Foundation of Nova Scotia regarding the Community Wellness Framework. Please set your phones to silent. Please be sure not to touch your microphones; staff will help with anything you need for adjusting.

 

I ask the committee members to please introduce themselves for the record by stating their name and constituency.

 

[The committee members introduced themselves.]

 

THE CHAIR: For the purposes of Hansard, I’d also like to recognize the presence of Chief Legislative Counsel Gordon Hebb and Legislative Committee Clerk Robin Dann.

 

I’d like to welcome the witnesses and ask them to please introduce themselves. We’ll start with the left.

 

[The witnesses introduced themselves.]

 

THE CHAIR: We’ll ask for opening remarks. Maybe we’ll start with ADM Stewart.

 

KIMBERLY STEWART: My name is Kim Stewart. I’m the associate deputy minister of the Office of Addictions and Mental Health and I am happy to join you this afternoon to speak with you about the Mental Health and Addictions Community Wellness Framework.

 

With me is Francine Vezina, our senior executive director, as well as three community organizations, all of whom do tremendous work in the community to improve access to addictions, mental health, and well-being supports here in Nova Scotia. The committee will know that the Office of Addictions and Mental Health was created in 2021 and has been working since then to build a universal mental health and addictions system of care.

 

When the office was formed, the team consulted with service providers, frontline workers, public health partners such as the Nova Scotia Health Authority and the IWK Health Centre, and people with lived experience about how we could build a system that works for all Nova Scotians. Using what we heard, a stronger, more connected mental health and addictions network is taking shape, one with more access points, fewer barriers, and more partners, including those from the public health care system, post-secondary institutions, the private sector, and community organizations.

 

I recently joined the office as the associate deputy minister, and I’m pleased to report there has been significant progress with the increased investment in public health care, more support for those struggling with substance use, and more support for youth with anchor youth spaces that have been opening across the province. This is only some of the work that is under way. There’s much more happening, like the supports and services funded under the Mental Health and Addictions Community Wellness Framework.

 

Launched in 2024, the framework was shaped by extensive engagement with health care partners and community organizations. Now, through the framework:

 

·       community organizations are receiving stable, multi-year funding. This means less paperwork and more time to do the work in the communities;

·       researchers are receiving grants to fund research focused on community wellness and the social determinants of health; and

·       community organizations now have more access to funding for shorter-term projects and initiatives.

 

In total, we’ve partnered with more than 40 community organizations who now receive multi-year funding; there are 23 that have the multi-year funding. That was awarded last year with the announcement of the framework. We’ve provided many short-term project-specific grants, which are administered by our partners at the Mental Health Foundation of Nova Scotia, who I’m sure will be happy to speak more to this in greater detail. We have also supported four research projects, with more to come. This means more data, more information, and more support for those who need addictions or mental health services and supports closer to home.

 

Thank you for inviting us here today. I look forward to your questions and to hearing from our partners here at the table with me about their initiatives that are making a difference here in Nova Scotia in people’s lives every day.

 

THE CHAIR: I believe Ms. Murray has opening remarks.

 

MARGARET MURRAY: Thank you for inviting my colleague Bev and me today for this meeting to discuss the Community Wellness Framework.

 

The Canadian Mental Health Association Halifax-Dartmouth branch is a grassroots charity supporting the resilience and well-being of people living with mental illness and mental health concerns through our social connection programs and projects and the provision of information, resources, and advocacy in a space that is inclusive, safe, and respectful. We strive to create an environment of hope, to reduce stigma, and to promote mental health for all.

 

We are part of a federated network of 330 independent Canadian Mental Health Associations across Canada united by a shared brand and vision: “A Canada where mental health is a universal human right.”

 

Also in Nova Scotia, we’re represented by three community branches - because sometimes people are not quite sure how this operates. We have three branches - the Halifax-Dartmouth Branch, Colchester East Hants Branch, and Southwest Nova - and we also have one provincial office, the Nova Scotia Division. We respond to local community needs while working together to advocate for policy change and to strengthen mental health supports across the province.

 

As was already mentioned, we were fortunate to be one of the recipients of a Community Wellness Grant. Our initiative is social connection for mental health and well-being. This grant has provided much-needed stability for us and an opportunity for growth during these challenging times for community agencies. To date, this funding has enhanced our current social connection programs and also allowed us to establish a new social well-being initiative as well as other activities. The other thing is that in addition, this has provided support to increase our volunteer base, which decreased during the pandemic.

 

I think we need to mention, too, that during the pandemic, there was a light shone on loneliness and social isolation. It really made people more aware, which is something we’ve been saying for many years - how devastating the impact can be on physical and mental health.

 

We certainly need to increase access to the right clinical care at the right time, but we also believe that mental health goes beyond treating illness - the social determinants of health. It’s about creating the conditions where people can be well and stay well by addressing urgent challenges like housing insecurity, poverty, barriers to employment, suicide prevention, and social connection and inclusion.

 

Our work has been guided by CMHA’s Framework for Support for over 40 years - to ensure that people live fulfilling lives in the community. This closely aligns with the Office of Addictions and Mental Health’s Community Wellness Framework. It recognizes the role that community-based organizations, first voice, and loved ones play in mental health and addictions care as we collaborate to achieve universal mental health care in Nova Scotia.

 

THE CHAIR: I think Mr. Guest is next.

 

TIM GUEST: Good afternoon, and thank you very much for the invitation to join you today.

 

The Nova Scotia Hospice Palliative Care Association was established in 1994 to promote the philosophy and principles of palliative care through networking, public and professional education, advocacy, and research. Today, our organization has evolved and we function as a provincial hub for equitable, compassionate palliative care and grief support, bringing forward the voice of community as we collaboratively work with community organizations, health care partners, hospice societies, providers, and government.

 

The Nova Scotia Hospice Palliative Care Association was selected in January 2024 as the Community Hub Organization to co-lead the implementation of the Nova Scotia Community Grief and Emotional Wellness Model with the Nova Scotia Health Authority.

 

A component of our work in this role included the development of our Healing Pathways Community Funding Program grants to support not-for-profit organizations to implement community-led initiatives addressing grief, bereavement, and emotional wellness. This funding enables local organizations to design and deliver supports that reflect the needs, culture, and realities of their communities. To date, we have distributed more than $940,000 to 41 organizations across the province. An additional $700,000 will be distributed in March of 2026.

 

Our second initiative, our Healing Pathways - Grieving Well database, was launched in April 2025 and is an online directory designed to provide information for individuals, providers, and organizations seeking supports, resources, and education on grief-related care and emotional wellness-related care and supports that are community-based.

 

Our third initiative that I wanted to mention for you today is a collaboration with the Nova Scotia Health Authority, where we launched the Nova Scotia Grief Alliance in the spring of 2025 to bring together partners across sectors to support networking, education, collaboration, and shared learning, with a particular emphasis on strengthening the knowledge and confidence of those providing grief and emotional wellness supports in communities from across the province.

 

At a time when the need for these supports is greater than ever, we remain committed to strengthening grief and emotional wellness across the province and appreciate the opportunity to discuss our work with you further.

 

THE CHAIR: Ms. Cunningham.

 

STARR CUNNINGHAM: I’m excited to talk to you more about the work that we do across the province. The Mental Health Foundation of Nova Scotia is the province’s only health foundation that’s solely dedicated to fundraising for mental health and addictions support. We exist to improve the mental wellness of Nova Scotians by granting funds to community-based mental health and addictions organizations. Our vision is to see all Nova Scotians thriving in their communities.

 

We believe in community because connection, belonging, and circles of support are fundamental to advancing mental wellness. We believe in compassion because kindness and understanding create nurturing and inclusive environments for growth, healing, and recovery. We are accountable because we exercise responsibility, oversight, and care for the lived experiences, relationships, and funds that are entrusted to us.

 

Our granting programs are at the heart of everything we do. Through the lenses of education, peer support, community, and connection, we fund programs from Yarmouth right down to Sydney and everywhere in between. We have five granting programs, with community grants being our largest. In 2024-2025, we awarded 375 grants totalling just over $4 million. Community grants accounted for 158 of them, totalling just over $3.2 million.

 

Much of that funding is provided through the Community Wellness Framework, allowing us to provide more mental health and addictions support access to Nova Scotians where they need it most, and that, of course, is closer to home. The foundation is incredibly grateful for this funding, as we see it as an important step toward achieving universal mental health care. We provide the office with regular reports four times a year, which highlight the area of impact, geographic location, number of Nova Scotians served, and financial details.

 

The foundation is really in a unique position because every grant application we receive tells us a story. It shows us what’s working and what’s missing in each community. It’s also timely and relevant because we call for grant applications every six months. We really have a pulse check of what’s happening in the field of mental health and addictions across the province. We receive hundreds of testimonials from Nova Scotians. I wanted to share one with you that really captures the essence of what we do. This is a quote: “I have made lasting friendships with people who have quickly become my go-to supports. The program has helped me feel less alone, more informed, and more connected - both as a caregiver and as a member of my community.”

 

Together with our individual and corporate donors, other foundations, community groups, and the Community Wellness Framework, we invest in projects that connect people, increase resilience, and offer hope to create a future where every Nova Scotian has a chance to thrive in their own community.

 

THE CHAIR: We’re going to move on to the question-and-answer period now. Each caucus has 20 minutes plus a second round of approximately 10 minutes as time allows. Questioning will wrap up at 2:50 p.m. We will start with the NDP. MLA Lachance.

 

[1:15 p.m.]

 

LISA LACHANCE: Thank you to everyone for being here. This is such a critical topic for our province. In 2021, this government promised universal mental health care. The Minister responsible for the Office of Mental Health and Addictions has said, and I have a quote: No matter where you live in the province, no matter what issue you might be facing or illness you’re living with, you can get the mental health and addictions care you need for free as part of our publicly funded health care system.

 

The universal mental health care portion of that was launched last year. We have a Freedom of Information request from December showing that 27 private practitioners signed on to deliver publicly funded universal mental health care. I’m wondering: Does that meet your target of practitioners for this program? I’ll direct that to Ms. Stewart.

 

THE CHAIR: ADM Stewart.

 

KIMBERLY STEWART: The work that we’re doing - access for Nova Scotians to be able to access the care they need anywhere, closer to home in the province, we’re doing that through the Community Wellness Framework, but specifically to your question about the 27 clinicians, we have launched an insured services program for those for mood and anxiety. That was launched in August, and we started taking appointments early in September. What we’re focusing on - there have been just under 1,000 more appointments available to Nova Scotians. This is through private clinicians. The insured services program is to align and work jointly with the public service to try to address some of the backlog we have in the system. There have been 1,000 more appointments.

 

We are working to onboard more clinicians, but we’re trying to do it at the right rate. We’re working closely with our partners in the health authorities to ensure that we have a community of practices being developed to ensure that the work between the private clinicians and public clinicians is aligned. We are making strides in that area. One thousand more appointments to just about 400 individuals.

 

LISA LACHANCE: Of the 27 signed on so far, only two are psychologists. There are eight social workers, and the rest are registered counselling therapists. I’m wondering: Does this reflect the level of care that’s needed in the community? You mentioned a community practice. I’m also curious about what other steps are put in place to ensure patient safety. If folks show up at the doors of a registered counselling therapist but need significantly higher levels of care, what happens then?

 

KIMBERLY STEWART: I appreciate the need to ensure that the appropriate level of care is being provided. I’m going to ask Francine to comment in a little bit more detail on that. We’re exploring options for those individuals.

 

THE CHAIR: Ms. Vezina.

 

FRANCINE VEZINA: The onboarding of the various clinicians - not only is it the most important part, being about the number of clinicians, but what we’re looking at is mood and anxiety disorder, and we’re looking at the non-urgent wait-list. What we recognized that we needed to do was to reduce the wait-times for those folks who are waiting for the non-urgent appointments and lower that to a 28-day wait time. In order to do that, the creation of more appointments for folks is what we’re looking at.

 

There’s also an IT system in place for us to be able to book those appointments and to do the piece that you’re referencing, which is our measurement-based care, looking at the outcomes in real time with those clinicians not just in the Nova Scotia Health Authority and the IWK Health Centre, but also you’re incorporating that into the insured services program. This will make sure that we’re getting the same quality of care for all individuals in Nova Scotia, regardless of where they’re accessing their mental health and addictions supports.

 

LISA LACHANCE: How do patients access this program? How are they triaged? Do people have a primary health care provider? What happens at the end of a set treatment course? What happens if they need a psychiatric consult? Are they back on the wait-list for that and have to scroll through all of that? I think it’s not clear to Nova Scotians how to access this.

 

KIMBERLY STEWART: There are many access points. For individuals, they can self-refer through a central intake line. They can come in through the community organizations. That’s part of what we’re here to talk about today - the Community Wellness Framework. That is a point of access as well. They will be assessed to determine what the appropriate level of care is for those individuals. It may be in the community organizations. It may be with clinicians. It may be in the public system.

 

That is really at the core of what we’re trying to do with universal mental health: to have different options for different people. People need different types of care. There are virtual options, and there are in-person options - but also to bring it to the community for individuals who understand the needs of their community better, to make sure it’s culturally . . .

 

THE CHAIR: Order. MLA Lachance is satisfied with the answer.

 

MLA Lachance.

 

LISA LACHANCE: Francine will know that I never come to these meetings without a long list of the wait times and the wait-time trends in mental health in Nova Scotia.

 

A couple of things: one is that it’s not stabilized. In non-urgent care across the province, I think if we went through quarter by quarter over the last few years, we’d see an advance in wait time - the 50th percentile for the first appointment - and then we’d see that disappear and we’d see wait times increase again. Across the province, wait times for non-urgent care are still exceeding any evidence-based target.

 

Folks who might access this universal mental health care would be part of the people who are on this wait-list and then would get screened in? So folks who come through community-based organizations - they also get put on the wait-list?

 

FRANCINE VEZINA: There were a couple of questions, so just repeat one if I happen to miss one.

 

With regard to the access to it - to back it up just a little bit, if folks call central intake - what was really important was to ensure the integration of what we’re adding on to the system with the existing system to create this one universal system. Calling the intake line, folks will be triaged. If there is the inability to provide an appointment in the public system within the 28-day wait time, folks are offered an appointment with a private clinician. They can accept or not accept. They’re not obligated to take one or the other. That would be targeted to be able to get to see them sooner. That’s sort of the entry into the system.

 

With regard to the wait times, unfortunately we’re always a quarter behind on the wait times. The wait times that are currently posted on the public website would be the last quarter, not the current quarter. If I remember correctly, I think the end of January the next will come out. What I do know . . .

 

THE CHAIR: Order. Thank you.

 

MLA Lachance.

 

LISA LACHANCE: I’m just going to stop you there to try to advance the conversation. As you know, we never have enough time.

 

This is the public data that I have available. It’s the public data that Nova Scotians have available to understand how it’s going, to understand how long they would wait for appointments. Across the province, Nova Scotians are waiting longer for non-urgent mental health care than they would have two years ago, if you look at the trends.

 

Looking at this, the vast majority of - in the last reporting period, there were four jurisdictions where you met that 28-day target, and the rest, you didn’t. For the 50th-percentile first appointment, which is that screening appointment - Dartmouth Portland Street clinic, 142 days. CBRM, 134 days.

 

I’m not suggesting that anyone’s happy with that. What we know is that people get sicker the longer they wait for mental health treatment. But why are we seeing Nova Scotians having to wait longer for the care that they need?

 

KIMBERLY STEWART: To Francine’s point about the stats and availability of data - since that data was released, we have had a thousand more appointments coming online to Nova Scotians. As she also said, they have the ability to choose between a public practitioner or to go into the private insured services. That will only continue to grow. The numbers - every week, when we see different numbers, it’s growing. I am confident that there will be more appointments available to address some of those wait times. The data that we’re seeing - we are reducing it. There is still a wait time, but we are working to reduce it.

 

LISA LACHANCE: I’m wondering, where did the 27 private practitioners who enrolled in the program come from? When this was launched, there was a lot of concern that we have vacancies in the public system for psychologists, and that most private psychologists at this point don’t have room for additional caseloads. Where did they come from? Were they public? Were they private? Did they come to Nova Scotia for this program?

 

KIMBERLY STEWART: The majority are currently in private practice in Nova Scotia. The 27 clinicians - we’re focusing on the appointments available as a better measure. They provide a minimum of 10 appointments per week. That’s mandatory - they have to make available. They’re doing it on the side of what their private practice already is, in addition to, and they’re making that many appointments available. That’s how - we’re focusing on the number of appointments, because some of them can do more. Some of them do the 10. That’s how we’re focusing on the appointments. There are criteria that have been put in place to ensure, again, the standard of care - there’s a rigorous process. We have a coordinator in the office who’s a clinician herself, who oversees all of that and is running the - is overseeing all of the work to ensure the quality and the alignment with the public system.

 

LISA LACHANCE: I had asked what happens when folks who are trying to seek mental health care in this province are on the wait-list, because there’s still a wait-list for all non-urgent care. Do they have a primary health care provider? If a clinician completes within the insured services a block of service, like an eight- or twelve-session program, what happens to that person then? Who does follow-up? How do they get follow-up?

 

KIMBERLY STEWART: One of the ways is there’s been the Rapid Access and Stabilization Program that has been rolled out. That is one way for those who are in the most urgent need - their physicians can connect in through that program and be put into more immediate need with a psychiatrist. That is one way that we’re trying to deal with the most acute cases.

 

There are many access points. We have an Access Wellness program that’s run by the Nova Scotia Health Authority. There are in-person sites around the province. There’s virtual. There’s phone. There is capacity in that. There isn’t a continuum of care, but it’s the ability to call and to speak to someone fairly soon - that one clinician. That’s a service that’s available through our YourHealthNS app. There’s a lot of information available there. There are other services and supports that individuals can access while they are waiting.

 

LISA LACHANCE: I appreciate that answer. I still think that Nova Scotians are concerned that the type of ongoing care you need for a long-term mental health concern - if you don’t have a primary care provider, it’s very hard to access, for instance, prescriptions and prescription renewals. I’m approached by people every week who cannot, through VirtualCareNS, have their prescriptions renewed. What that also means is that people are not going to stay well. It’s just creating a system where people - we invest - people have access to a service and then there’s some backsliding.

 

I guess that’s my question. I’ll leave that question for now. It’s really not clear to me how people will get the type of follow-up service that they need if they don’t have access to primary health care.

 

I wanted to give some time and turn to some of our community associations who are here. Perhaps I’ll start with the Mental Health Foundation of Nova Scotia. We looked at - there was some data over the holidays that was released that showed Nova Scotians being less satisfied with life than the average Canadian. With the everyday Nova Scotians who you interact with, who your partners interact with, what needs do you see in the community that are currently unmet? What are the service gaps that you’re seeing?

 

THE CHAIR: Ms. Cunningham.

 

[1:30 p.m.]

 

STARR CUNNINGHAM: In my opening statements, I commented that every grant application tells us a story. It shares with us what is working in the community and where some work needs to be done. We review that and pull out some main themes. The main themes that we’ve seen in the last six months into the last 12 months have been mental health supports for caregivers: the loved ones and people who are taking care of the people who are struggling with their mental wellness or living with mental illness and addiction. We have also seen more applications identifying newcomers as an area of the population struggling to access mental health and addiction services.

 

It’s interesting - bereavement has been more on our radar in the last 18 months than it ever has before. We’re hearing from more communities and individuals who need help dealing with grief. Perinatal health is also on the list for the first time. We have had some grant applications in that field before, but we’re noticing more of them now. The other one I’d say is IPV - intimate partner violence. I don’t think that’s a surprise to anyone in Nova Scotia, but we have been seeing more applications for organizations looking for more support funding the mental health and addictions component of that.

 

LISA LACHANCE: The second part of the question is: Those are the trends; that’s what you’re hearing people need support with. Where do you see the biggest gaps in services when people come to you and say, “We want to support survivors of domestic violence, but . . .?”

 

STARR CUNNINGHAM: I think it’s in easy, accessible mental health counselling. It’s people wanting access to services in their community when they need the services. It’s about easier access to that one-on-one counselling as opposed to - peer support is fantastic and we support a lot of it, but we do see a growing demand for one-on-one counselling. We do provide funding to organizations. I think of Couch of H.O.P.E., for example, which operates in Dartmouth and provides free counselling to people who don’t have private insurance and can’t afford it, and other organizations similar to that across the province.

 

LISA LACHANCE: When folks are waiting - when folks can’t get access to that counselling that they want and that they probably need - what happens then? What’s their experience then?

 

STARR CUNNINGHAM: We do our best to connect them with services that are in their community, with community organizations that are providing the work. We also provide them with resources. We’re not mental health clinicians, so unfortunately, we’re not able to help people directly with their specific problems, but we are certainly able to put them in touch with other organizations and other departments that do.

 

LISA LACHANCE: I’m actually going to hop back to the office just quickly. Hopefully an easy question, just following up on the meeting on Integrated Youth Services and the anchor youth space program in Nova Scotia. I’m wondering: The expectation was there’d be an additional site up and running by January 1st. I’m wondering if that’s happened and if you can confirm the level of service that has been found through anchor programs in terms of numbers of youth and/or numbers of hours.

 

KIMBERLY STEWART: There are three sites up and operating now: Halifax, Amherst, and Sydney. There are five more that are opening; there are five more that are planned. There’s a second one in HRM, Bridgewater, New Glasgow, Eskasoni, and Yarmouth. There are plans for those to be opening before 2027. My understanding is the uptake - I can get specific numbers for you - but the uptake has been very good at the anchor youth sites. I went to an opening in August myself, and I was really blown away at the participation of the youth and how they showed up and the collaboration that has been done in the communities with those youth.

 

One of the things they said that really struck me in the opening remarks was, “All the youth have to do is get here.” By getting there, there are so many onboarding ramps for them to access clinicians, to access - we hear in Amherst that one of the things that they’re accessing is the washing machine, to be able to come in and wash their clothes, the life skills, the assistance, having jobs, school support, but also again, the mental health supports, the counselling, and some navigation to help them access the various things they need in the system.

 

THE CHAIR: MLA Lachance, there are four seconds left.

 

LISA LACHANCE: Thanks, folks. (Laughter)

 

THE CHAIR: We’ll move to the Liberal caucus and MLA Rankin.

 

HON. IAIN RANKIN: I want to thank everyone for the important work they do in such an important field, especially with the growing issues that we’re seeing in mental health and addictions. I’ll ask a revenue question first to the Mental Health Foundation of Nova Scotia, if I could. I know parking has now been made free for visitors to the hospitals. I’m just wondering: In terms of that revenue that foundations have counted on, is that now streaming to the foundation to ensure that there was no revenue lost to meet the commitment from the government?

 

THE CHAIR: Ms. Cunningham.

 

STARR CUNNINGHAM: My understanding is that there is not a revenue stream replacement that’s in place. The Mental Health Foundation of Nova Scotia did receive funding from parking revenues, but ours were never high enough to really impact our bottom line much. I know there are other hospital foundations across the province that rely on that money. It’s my understanding that they have not received any funding to make up what they would have received had parking not been free.

 

IAIN RANKIN: Maybe I can redirect to the government representatives who are here. I think it’s an important commitment. I think the Premier himself made it - that he would make sure that he would keep those foundations whole with the revenue that has been missing. Obviously, they do important work; I don’t have to reiterate that. If you could give a timeline to the committee on when that revenue will be replaced or if there is no longer that commitment.

 

THE CHAIR: ADM Stewart.

 

KIMBERLY STEWART: I’m not able to provide specifics on a timeline. That is something that is really with our partners in the Department of Health and Wellness, but I’m happy to take that back and find out.

 

IAIN RANKIN: I think that’s disappointing, to say the least. This is really important work that I think all the members on the committee want to see continue with the foundations. If you could get back to the committee, or the Department of Health and Wellness - if we could ask to get answers on . . . (Interruption)

 

KIMBERLY STEWART: I can confirm that we have recently signed an agreement with the Mental Health Foundation of Nova Scotia to extend our agreement for an additional three years. That has been recently signed, but I appreciate what you’re saying.

 

IAIN RANKIN: I appreciate that. Something that stood out to me in opening comments, Associate Deputy Minister, is that there’s a statement that there has been significant progress and increased investment in public health care. That’s a significant statement in the context of Nova Scotia, because historically - for those who follow public health funding - we have been laggards. This is not political. It’s been the case in Nova Scotia, compared to other provinces, as a percentage of the health budget. It’s been hovering around 1 to 2 percent for a long time. Experts think that we should be getting closer to around 5 percent like other provinces spend.

 

Can you quantify that statement that there’s been increased investment in public health care? We heard today about an increase in health spending overall of 50 percent. This is kind of a budget question, but also asking the department to actually prove that there’s been an increased focus. Out of the $6 billion being spent on health care, how much of the percentage is Nova Scotia spending now to back up that statement?

 

KIMBERLY STEWART: Our budget is $363 million. That’s the biggest investment in mental health and addictions in the history of our province. The majority of that budget does go to the Nova Scotia Health Authority and the IWK Health Centre for the public system. With respect to community, we are investing just over $30 million a year in community options and access points within the community.

 

IAIN RANKIN: When I read public health care, what it says to me is preventive health care - health care for community-based care, and trying to help the whole wellness relative to the topic today. Correct me if I’m wrong, maybe you’re speaking more with this statement that it’s dedicating money for publicly funded health care. That may be the more appropriate statement that I’m reading from the intro. Okay.

 

I’d like if you could provide to the committee - I think experts really in this field are interested in what Nova Scotia is spending as a percentage of the global health budget on preventive health care. It has been something that I think we can all agree that Nova Scotia can catch up on. Is that possible?

 

KIMBERLY STEWART: When you say part of preventive health care, are you speaking more broadly about health care or specific to mental health?

 

IAIN RANKIN: The whole gamut of health - preventive health care, treating the wellness as opposed to treating the illness and ensuring that we are upstream in investments in preventive health teams and community-based health care.

 

KIMBERLY STEWART: I can speak to the mental health and wellness aspect of that and what we are trying to do with the Community Wellness Framework. That work is really to invest early on in the community. That is focusing on mild to moderate so that individuals - we hopefully are able to treat them and provide them with the care they need before things escalate to when they do need the formal system and they do need the clinicians. But those organizations are then able to refer in as needed for that more formal care.

 

IAIN RANKIN: That’s fine for today. Whatever information you can provide would be great.

 

I want to talk about youth mental health and Children’s Intensive Services and Adolescent Intensive Services. We have day and in-patient programs for youth under 19 with mental health and substance-use disorders. I want to ask first how many CIS and AIS beds we have as a total aggregate in the province.

 

KIMBERLY STEWART: I’m going to refer that to my colleague Francine Vezina.

 

THE CHAIR: Ms. Vezina.

 

FRANCINE VEZINA: Hi. I’m sorry, we don’t have the data or that information with us today. The number of beds and the data with regards to the acute care mental health and addictions system - we can get that to you and provide that information.

 

IAIN RANKIN: That’s interesting. Can you at least say how many beds, or if there are any beds outside of Halifax?

 

FRANCINE VEZINA: Any AIS or CIS beds outside of Halifax? No.

 

IAIN RANKIN: Can you say if any beds are available on weekends?

 

FRANCINE VEZINA: For the AIS and CIS programs, they run Monday to Friday. But although those beds exist in Halifax, they are provincial. It’s a provincial service.

 

IAIN RANKIN: Given that it’s a provincial service, is there transportation available for those living outside of Halifax to get to those beds?

 

FRANCINE VEZINA: Yes, if families speak with the care teams, they have a variety of ways or resources available to them.

 

IAIN RANKIN: Would that include services to get those patients back home on weekends, given that those beds aren’t open on the weekends?

 

FRANCINE VEZINA: I can’t speak to specific parameters. What I do know is that they have supports available to support travel for family and the individuals accessing the service.

 

IAIN RANKIN: I understand from staff who are working at these facilities that the work is very challenging and could become a bit of a safety concern. I’m wondering if there’s security provided at these places to help with staff concerns.

 

FRANCINE VEZINA: They do have access to services available through the IWK facility or the organization itself that they can draw on.

 

IAIN RANKIN: My understanding is that there are not security services available. I’m wondering if you have the data on the longevity of the staff working in these types of environments, if you have that - how long staff are actually staying and working in this field.

 

KIMBERLY STEWART: We do not have that data. That is something we would have to work on with our partners at the IWK Health Centre. They are operationally responsible for these areas. But we can get that information and get it to you, for sure.

 

IAIN RANKIN: Do you track any kind of data - again, my understanding is that this is a field that is very challenging to work in and has retention issues. Do you have the data to show the kind of retention that is available in this field? Can you provide that kind of data to the committee?

 

[1:45 p.m.]

 

FRANCINE VEZINA: No, we don’t have that here.

 

IAIN RANKIN: Is the department saying they don’t track any data in terms of staff feedback or anything related to working in this field at all?

 

FRANCINE VEZINA: Absolutely, we collect all of that data, but the majority of the data that we would have brought with us today would have been focused on the Community Wellness Framework.

 

IAIN RANKIN: Maybe I can ask: When patients turn 19 - I think this is important with the transition into the adult mental health system - what are we doing to ensure that the work continues and that there’s a smooth transition into the adult-related field?

 

KIMBERLY STEWART: We work collaboratively with the IWK Health Centre and the Nova Scotia Health Authority. In the work we’re doing to provide the universal access that is our mandate to do, we have a steering committee that is composed of myself and the VP of the health authorities. We work very collaboratively on all of the different services being provided. The health authorities are operationalizing this, but we provide policy and direction, and we do connect on a very regular basis. That is something that is a very crucial part of the discussions we have at that level.

 

IAIN RANKIN: We know that a lot of this issue relates to homelessness. I want to ask the department if they track whether this program effectively lowers the risk for homelessness for its participants once they’ve gone through the program. It’s said that there is some data that’s tracked related to staff. I would think this would be a very important piece to ensure that we’re doing all we can to gauge the effectiveness of the program - if, at the end of the program, we see Nova Scotians without a place to live.

 

KIMBERLY STEWART: We have seen rising numbers of homelessness. It’s becoming more visible. That is a trend across Canada. We are working closely with our partners in the Department of Health and Wellness, the Department of Opportunities and Social Development, and the health authorities. We have a mobile outreach unit. We’re working with the North End Community Health Centre here in the HRM to provide those services to those - through our Community Wellness Framework, we are funding a number of organizations that are working with those who are unhoused who have concurrent mental health and substance abuse issues. It is something we are working with. It’s something that as government, we can’t do as an office alone; we really have to not have the silos and work across the various departments to address this need.

 

IAIN RANKIN: When the framework was announced in the spring of 2024, it didn’t really come with a budget. Since then, we’ve had some announcements roughly painting a picture of how much is being spent on the program. Perhaps for more clarity, how much was initially budgeted for each of the three funding streams? You have the project stream, the MHA Community Wellness Grant, and the research and innovation stream.

 

KIMBERLY STEWART: For the multi-year grants, which are the community wellness grants, we provide just over $4.5 million per year over three years. For the one-time grants, it’s $1.75 million that goes to the Mental Health Foundation of Nova Scotia. Again, we just signed a new three-year agreement with that organization for three more years of funding. For the research and innovation stream, there’s $400,000 that was awarded to four different organizations. That’s work we do with Research Nova Scotia. Just yesterday, we announced that there would be $400,000 more available to more projects. That’s specific to the framework, but the broader amount that we spend annually in supporting work and work in the community is just over $30 million.

 

IAIN RANKIN: Is there another cohort of applications that will be opening up soon for this program?

KIMBERLY STEWART: For the framework or for a specific stream?

 

IAIN RANKIN: For the projects.

 

KIMBERLY STEWART: For the project stream, I believe there will be another call for applications, but I’m going to defer to my partner at the table who can speak in more detail to that.

 

STARR CUNNINGHAM: Our grant applications are open right now, and they close coming up the third week in January. Then our committee will be scoring and reaching out to successful applicants by end of March, early April. Then our grants will open again. Every six months, we’re opening a new call for grant applications.

 

IAIN RANKIN: The Garron family announced $25 million to the IWK Health Centre in 2024, earmarked for intensive services for children living with mental health and addiction. Do we have a timeline proposed for the mental health and addictions ecosystem at the IWK?

 

KIMBERLY STEWART: I do not have the timeline for the longer term. I know significant investments have been made in the Garron Centre. I recently did a tour of it, and that is a place for youth at the Tier 5 level of care that come from across the province. Some of the money has been used to invest in that site. As for the remainder of the donation, I do not have the specific timelines, but we can get back to you.

 

IAIN RANKIN: Along the same lines, the funding was announced to be intended for that increased intensive rehabilitative, more in-patient care that can only be possible with those in-patient units. I’m just wondering if you can give an expectation on when the in-patient beds for children and youth will be open at the IWK Health Centre.

 

KIMBERLY STEWART: Those beds are already available in the Garron Centre in the IWK. The capacity has expanded there. I cannot say the exact number, but I will find out. I believe those in-patient beds have already been expanded.

 

IAIN RANKIN: When the Mental Health and Addictions - Community Wellness Framework was published, it included a list of intended outcomes with indicators and the method of data collection for short-, medium-, and long-term projects. Data collection methods included community-based organization surveys, data asked from StatsCan, NSCHA information, and Engage Nova Scotia Quality of Life Survey. What time periods are being considered for short-, medium-, and long-term?

 

FRANCINE VEZINA: We’re early yet. Most of the community-based organizations received their funding at the end of March, beginning of April in 2025. We’d be looking at, yes, short-, medium-, and long-term goals. What we do collect from them are quarterly reports. We have a dedicated community liaison position that is new and is involved in the accountability and collaboration relationship with community-based organizations. That is also strengthening our relationship. They provide annual reports, which speak to the indicators that you are speaking about that were in the logic model.

 

Once everyone has completed their first year of funding and has the opportunity to complete their final reports, what they’ll do is submit them to the department and we’ll be able to measure them up and report back on them according to the logic model or evaluation plan, and talk about those indicators and outcomes from the community wellness grants.

 

IAIN RANKIN: The longer-term indicators of outcomes will be largely based on the Engage Nova Scotia Quality of Life Survey, and according to their website, the 2025 survey has been postponed. If this survey is being delayed, how is the department assessing the outcomes and indicators of the funding?

 

FRANCINE VEZINA: We have an evaluation plan that is specific to our universal mental health and addictions continuum, and part of that continuum is the Community Wellness Framework. We will work within the office to look at those indicators and to measure them using the data that we receive from the community-based organizations until such time that the survey takes place.

 

THE CHAIR: MLA Rankin with 55 seconds remaining.

 

IAIN RANKIN: I think I’m good for now. I appreciate the answers.

 

THE CHAIR: We’ll move on to the PC caucus. We’ll start with MLA Hilton.

 

NICK HILTON: Thank you, everyone, for being here today. My mind is always working, especially when we’re having so much great conversation and input on what’s going on in Nova Scotia right now when it comes to mental health and addiction. I spent a good part of my nursing career in and out of the mental health and addiction departments in the Yarmouth Regional Hospital. We’ve seen a lot of good things happen, some decline over the years, but recently a lot more improvement, a lot more good conversations specifically around the Community Wellness Framework and some of the organizations in our community that have been funded. Yarmouth is well represented on the grants list.

 

I’ll probably have a few more questions for you a bit later, but I know we’ve been focused on the department - so just a couple to the department to begin with. I will say, around wellness and prevention, it’s nice to talk about that, because normally in health care, we’re focused on the disease, and at that point, you don’t see a lot of cost savings. To work on wellness, prevention, talk about things like the Integrated Youth Services hub that hopefully we’ll have a grand opening for in Yarmouth sometime in the next year; a thousand more appointments; believe it or not, free parking at the hospitals was a positive thing, and hopefully we’ll work all that out as well as we get moving along.

 

Could the department please outline the various streams of the Community Wellness Framework and how they work together to advance community-based and universal mental health care?

 

THE CHAIR: ADM Stewart.

 

KIMBERLY STEWART: The Community Wellness Framework, as I’ve said previously, is really part of our commitment to develop universal access to mental health and addictions care in the communities closer to home for individuals where the communities understand the needs of the people who live there. Again, early intervention - provide the services early before it escalates and more intervention - is needed. Really, it’s about providing more access points so there are more ways to access the various services. Government is also leveraging the skills of the universities and post-secondary institutions. We’re working with our partners - again, those community organizations - but also with the public system.

 

The three areas - we’ve spoken about the project stream, the longer-term funding stream, and the research. What we heard through all the engagement that was done in developing our universal mental health strategy and the Community Wellness Framework was that these small community organizations - this is probably true of many sectors - spend a lot of time writing grants to government to access money. Really, at the core of this is providing the stability so that they’re able to hire the staff they need, have a little bit of predictability over three years, and they’re able to do the work.

 

We put the appropriate accountability in place with the reporting that Ms. Vezina had spoken to earlier, but that really is the aim of that stream, to provide that stability. The project fund, which Starr Cunningham can speak more to, is to focus on those individual projects. Are there specific things that can be done in a certain area to enhance the mental health support, to complement, again, the longer-term funding? The research works together to inform all of this work.

 

NICK HILTON: Just thinking about how we got to this point, what are the differences with this type of framework versus what we were doing before? Were we doing anything to move to more easy access to care, early intervention, the wellness side of things? What are the positives that we’re doing now?

 

KIMBERLY STEWART: One thing that we are doing is the office has been funding these community-based organizations for a long time. The Community Wellness Framework is a new way of doing it. We are working to bring some of our historic work under, so there is an alignment and the accountability is in place for all of those organizations. That’s one of the primary differences. The other difference is - again, it comes back to the system of care that’s being created, so that it’s all working together in tandem, so those who are accessing the services at the community level have more access points for those in the rural communities to then feed into the larger, more public system.

 

NICK HILTON: In your remarks, you mentioned your department is investing in more than just community-based organizations to build universal access to addictions and mental health care. Can you just give some ideas or suggestions of what those other organizations are? Besides Integrated Youth Services hubs, is there anything specific we’re doing to support young people specifically?

 

[2:00 p.m.]

 

KIMBERLY STEWART: One of the things I can speak to is that in community but outside of the framework in seven different communities, we are providing funding for clinicians to be in the communities. That is one area.

 

The insured services program that we spoke about early - that is also available for youth - to your question about the youth - and anchor youth spaces can also access the ISP services.

 

NICK HILTON: I think sometimes we lose a little bit of focus on the positive because we know that people are struggling. We hear that in our offices. It is nice for us to have options and places to send them, many of them supported by the framework and the grants that your organizations provide. Hopefully we’ll continue to see that and continue to see more investment in mental health and addictions as we move forward. I know there are many more organizations that I’m sure you’re getting proposals from to help solve some of the issues or work with some of the individuals in our communities. We’re really supportive of the work that you’re all doing. Like I said, this work is great.

 

What about the clinical space? When someone needs a higher level of support - I know that some of my colleagues have touched on that, but if they need support from a clinician or a psychologist - can you just elaborate on what that connection looks like?

 

THE CHAIR: Ms. Vezina.

 

FRANCINE VEZINA: If individuals are looking for help, the immediate would be the crisis line, if it needs to be right away. We have a 1-888 number, and we also have 988. This is all self-referral.

 

There is also the central intake line that folks can access. They receive an assessment, and then they’d be appropriately matched to the right level of care. 211 is a wonderful community resource. Not only would they connect you to services within mental health and addictions but also any other needs related to the determinants of health that an individual may experience in a given time.

 

There are a number of virtual services that are available directly online for folks - a number of helplines also available through 211 that folks can call to receive help. There are also peer-support services available through the intake line that individuals can access and that can be helpful in particular circumstances.

 

NICK HILTON: Just one follow-up. From my previous work, I actually used to be the intake worker in Yarmouth, covering a maternity leave. You never knew what was coming in the office door, but you always had some very - almost life-changing conversations with individuals - hopefully more positive than anything.

 

I know with the central intake line - that’s relatively new in the past few years, and there were some bugs in the initial startup, but I feel like I’ve heard good things about wait times and when individuals will be called back, or if they’re picking up live. Can you share anything positive about how that process is going and where we stand now?

 

FRANCINE VEZINA: This data - it can be tricky, because it’s point in time. MLA Lachance already mentioned the data being a quarter behind. It can be discouraging for folks.

 

What I know to be the case at this particular point in time is that calls are being answered within three minutes, typically, for the crisis line. We know that for an intake appointment, it is typically being returned, if not answered live, within three days. We are up to 80 percent of folks being given an appointment time within that 28-day barrier.

 

There are always improvements that we’re making. We are, through the strengthening of the continuum of the service and proper matching folks to the appropriate level of care, trying to make a greater impact there and trying to reduce those wait times.

 

THE CHAIR: MLA Robicheau.

 

RYAN ROBICHEAU: I know that new programs can be difficult, and you need to learn and you need to adapt. How will the Office of Addictions and Mental Health continue to strengthen collaboration with community organizations to ensure universal access remains sustainable and effective across all regions of the province?

 

THE CHAIR: ADM Stewart.

 

KIMBERLY STEWART: To your point about the insured services program, it is a first in Canada, so there have been learnings, and we are continuing to adapt. Specific to your question about the communities - the position that was created within the Office of Addictions and Mental Health - we have the community liaison role. That individual is in regular contact with the communities. The office sees that as a very vital role, because the input from those groups really informs the work that we’re doing in the office.

 

I would like to pass it over to one of my partners here at the table to maybe speak a little bit more about their role in informing.

 

THE CHAIR: Who would like to speak? Mr. Guest.

 

TIM GUEST: We have a process where we meet with community on an ongoing basis through the year. As part of our work, we do community-based needs assessments. We take the information from those needs assessments, but also the information that we get on the evaluation from the grants that we provide community-based organizations, and that becomes part of an annual report that goes to the department every June. We write it as the voice of community going to government. It’s very much us passing their perspective on. That would be one mechanism that we use.

 

RYAN ROBICHEAU: I’m from a rural area, and we do have a great medical centre in Clare. There are also resources in Yarmouth, the neighbour to our constituency. How is the office planning to address gaps in access to rural and remote communities to ensure universal mental health and addictions care truly reach every Nova Scotian, specific to rural?

 

KIMBERLY STEWART: We’re working to provide access to all Nova Scotians as close to home as possible. Again, it’s back to the continuum of care and the access that we’re providing, whether it’s through the virtual appointments, through the in-person centres. There are 12 recovery support centres that have been opened across the province - through the Nova Scotia Health Authority - where people can receive clinical care. There are the hospitals and the emergency departments, the community clinics with our public partners in the health authorities. The anchor youth spaces we’ve already spoken about - they’re a really key one for youth. A lot of on-ramps there and ability - really, it’s very similar to primary care. There are many access points.

 

Part of what we’re doing to build the universal access to the mental health care and addictions is to have the various options, and through our Community Wellness Framework is to have those in the rural communities. It’s not all just in Halifax.

 

RYAN ROBICHEAU: Those are all my questions, but it’s good to see where we’re at now and where we’re going. It seems like there are a lot of good things. I’ll pass on my time to my colleague.

 

THE CHAIR: MLA Corkum-Greek.

 

HON. SUSAN CORKUM-GREEK: I’m always cognizant that on one hand, we have just two hours, and we want to use our time especially well. It’s not two hours at all. You have all left your offices and the mound of work and duties and your mission - critical - to be here with us today. My question kind of loops into that and the use of time. It is directed at our partners outside the department.

 

Before politics, I worked for a non-profit. It was a charity, in fact. It was not in health; it was in arts and culture. I thought it was very important. I still think it’s very important, but I cannot, even myself, begin to suggest that it is as critically important and essential as the work that all of you are involved in; but I know the cycle and how much time historically is tied up in the applications for funding to do the things you do. The reporting - and my gosh, you’re just reporting on the last one when you are applying for the next one. So I have my own opinions on the cost of all of this pulling you away from mandate, adding additional challenges to keeping quality people because you ultimately can say, “I will do my best to keep you. You are great,” but you maybe can’t sign a contract beyond a certain period of time.

 

What I’d like to hear from all of our agencies and foundations represented here is your description of how, through this framework and the ability to help multi-year funding - not my words; I’m a member of government and might be suspect with my opinions - but for you, how that change has made a difference. If we can give all those who’d like to speak an opportunity, please.

 

THE CHAIR: We’ll start with Ms. Murray.

 

MARGARET MURRAY: Thank you for acknowledging that. I think for anyone working in a charity or mental health and addictions charity, that is very true - in all charities. Anyone who is in a senior position, you are not only spending a lot of time writing grants, you’re also fundraising and going with donors. Sometimes it aligns, but other times you’re really feeling taken away from your important work.

 

I had mentioned in my initial comments that receiving this grant for multi-year, it did provide a sense of a little more stability and the opportunity for growth. The opportunities you so rightly mentioned about the staffing. Actually, to add a more personal note to it, even with one of the positions that we were able to create from this grant is an outreach worker and volunteer coordinator. This individual is mainly tasked with working with our Building Bridges program, which has been notoriously underfunded because it’s a one-to-one small group program and social connection.

 

As this individual staff person has been meeting people, they’re saying to her: This is more than six months or this is more than a year. When we explain how this funding has worked - just the positive feedback. It’s not only us doing that work and having some relief that we have some multi-year funding, but also - and I’m sure it’s no different in other organizations - when people start hearing that there’s been some investment in community-based organizations - and believe me, everyone does - we also want specialized care and more clinical care, but in the whole mental health care continuum, organizations like ours do play a role. So it has provided a sense of relief and some stability, so thank you.

 

THE CHAIR: Would anyone else like to speak to that? Ms. Cunningham with 54 seconds remaining.

 

STARR CUNNINGHAM: I’ll be speedy. For us, it’s allowed us to invest in technology to make the granting process more streamlined and not as manual. We’re not working with Excel spreadsheets anymore. By making a commitment to three years of funding to the Mental Health Foundation of Nova Scotia, we’re able to use some of that funding to make it easier for our community applicants to apply and, in turn, for our organization to process them.

 

THE CHAIR: Would anyone else like to speak to it? Mr. Guest.

 

TIM GUEST: I can’t really answer the question because we’re one of the organizations in this place that hasn’t moved into the multi-year funding yet; we’re still working on the annual. The one thing I can say is that the funding has certainly helped us to be able to be a support for small community-based organizations that don’t necessarily have the capacity and the people to do some of the work.

 

THE CHAIR: Order. Thank you, Mr. Guest.

 

We will now move on to our second round of questioning which will be 12 minutes per caucus. We’ll start with MLA Wilson.

 

ROD WILSON: Thank you, everyone, for coming today. I know some of your great work first-hand, so thank you, and thank you for taking time.

 

I want to follow up on the question we heard from Ms. Cunningham, her responses. What are the needs of your clients that aren’t currently being met? What resources would you need to meet those? I’m thinking particularly with CMHA.

 

THE CHAIR: Ms. Cunningham.

 

[2:15 p.m.]

 

STARR CUNNINGHAM: I think it’s a CMHA question.

 

THE CHAIR: Ms. Murray.

 

MARGARET MURRAY: I think we can all acknowledge - when I think - I mean, certainly we’re here talking in our programming about social connection and loneliness and social isolation but also needs not being met. Many people we serve are currently feeling more marginalized because of the fears of losing housing or spending - I know someone who’s spending 90 percent of their disability pension on rent, and trying to encourage that person to get the rent subsidy.

 

That right now, as we’ve been reflecting - Bev and I both - on the past many years that we’ve been here, we’re so encouraged by some of the developments, like trying to provide more help at the right time - that no door is a wrong door. But at the same time, so many people who, for example, our local branch would serve, are experiencing - living in poverty and housing insecurity. Those struggles have increased. That’s not just in our organization. I think one thing we do is we do provide that sense of belonging and someplace for people to perhaps take a little break from that - and in some cases struggling to get the right services in the mental health system. As we mentioned at the beginning, if we can address the social determinants of health in a more integrated way, then perhaps when people we know are living with severe mental illness or substance use issues, there would be more services for them to access.

 

I think it’s just a struggle. It’s a struggle for a lot of the people we serve, just meeting their basic needs every day. That’s not just here. That’s across the country. But certainly in Halifax, with the housing situation - we’re involved. I mean, yes, we run social connection programs, but we also get a lot of calls from the public, and we end up - as people have no one else to help, we will advocate individually on their behalf.

 

Trying to help people apply for the rent subsidy and trying to encourage people to get the disability benefit, for example - that was a big issue for us last year. A lot of people who really would qualify - for the disability tax credit, I mean - hadn’t applied for it because they didn’t pay taxes. When the disability benefit came out - I don’t know if you’re aware of that federally - which is $200 a month, we spend a lot of time - because people were saying “$200 would make such a difference,” but the effort to struggle, to go - or even if you don’t have a primary care physician - that was quite an effort for people. Some people did try to go ahead and get that, but that’s - so it’s financial.

 

Some of the other struggles - I just want to quickly mention something that was asked about accessing medication. That was something that we were seeing a lot of - people not being able - people might come to our door or call, but also individuals accessing our programs, if they lost their primary care provider and didn’t have anybody helping or any clinicians working with them, such as a psychiatrist, they couldn’t get some of their psychotropic medications renewed. We were seeing people having to go to emergency departments.

 

That is just an area I wanted to mention where there has been some improvement. People can now go through that RASP program and quite quickly get their medications reassessed. We’ve known some people where that’s really worked for them, and even through Maple, because none of the local walk-in clinics will do that.

 

Those are just a few of the things that we’ve seen that people - it’s just more of a struggle. We really have to address the social determinants of health.

 

Would you add anything, Bev?

 

THE CHAIR: Ms. Cadham.

 

BEV CADHAM: I think, too, when people walk through our doors and they know that they’re getting a social connection and it’s addressing the loneliness piece - that component is significantly vast in our communities. It’s global. I think just navigating a system is complex. There’s literacy involvement. There’s cognitive involvement. There’s mental health involvement. There may be some addiction use there. I think coming where they can build a rapport with other people who are living in their shoes as well, but also getting the assistance from a team of individuals who actually understand - everybody who works at our branch has a connection with mental health in some way, shape, or form. They’re speaking with people who have lived experience through relatives, loved ones, or their own personal experiences. I think navigating that system is something that we can provide, and building a sense of trust or connection.

 

THE CHAIR: Order. MLA Wilson.

 

ROD WILSON: I couldn’t agree more. Obviously, affordability is affecting people’s mental health. My last question is directed to the associate deputy minister. We heard that there are - correct me if I’m wrong - about 400 individuals involved?

 

THE CHAIR: ADM Stewart.

 

KIMBERLY STEWART: When you say 400, are you referring to the insured services program? I can get you the exact number, but it’s just under 400. I believe it’s 392 or 382 are accessing care with a private clinician through that program.

 

ROD WILSON: So 400 in a population of one million is not a lot, which brings me to my question: What’s the wait-list time? Also, we know from the data that shows that the time from seeing - attachment to access varies. In one case in the Annapolis Valley, it’s up to 88 days for first treatment, which is almost three months. That’s not discouraging; that’s distressing. My questions are: What are your total wait times for universal? Do you have any set goals for the coming year? What do you say to people who live in one area who wait three times as long as the other parts of the province for the first treatment?

 

KIMBERLY STEWART: We are working to continue to build access and to strengthen the system. We are working closely with our partners in the Office of Healthcare Professionals Recruitment. We are working closely with them, because recruiting new clinicians is a very important piece of this, as well as working with our partners in the post-secondary institutions. That is one way we are working, is to have more clinicians available.

 

As we’ve said earlier, the 1,000 more appointments, that is just since September. That will continue to grow. Agreed that with a population our size, 400 is not a large number, but it is growing, and it will continue to grow. We are continuing to invest in that and to work with our health care partners to recruit more clinicians into the insured services program.

 

ROD WILSON: One thousand appointments is great, but what’s the wait-list and what’s the target for 2026 for how many people to be actually accessed, attached, and seen?

 

THE CHAIR: Ms. Vezina.

 

FRANCINE VEZINA: I don’t know if there’s a specific target of number of people or appointments per se. We’ll continue to add as we can. What I will say is our target for wait times, however, is within 28 days for non-urgent. That’s always what we’re thinking of. This isn’t the only solution to lowering the wait times. The investments in the public mental health and addictions care system will contribute to that, as well as seeing people easier and doing prevention and recovery types of activities, such as our community-based organizations in the Tier 2 space. It hopefully will prevent folks from needing the formal mental health and addictions system.

 

ROD WILSON: I’m looking for more specific goals: 400 people have accessed it, but how many people are waiting, whether there are 1,000 appointments or 2,000 appointments, and do you have any goals about the number of people you hope to try to get seen in 2026? Not the number of appointments, but the number of people that you want to get off that wait-list.

 

FRANCINE VEZINA: Not specifically, because so much actually weighs into that particular answer. Ideally, if we could back up the bus and we were doing more prevention so that fewer people needed it, then the number of people needing the higher tier service, or Tier 3 and above services - there are benefits; there would be a good-news story of seeing that lowered in the situation where it’s because we’re catching things earlier. So there’s too much context around an ideal number that we would want to see in the run of a year.

 

ROD WILSON: Again, I’m struggling with how you determine how many appointments you create without a goal or describing how many people need to be seen. Here’s the need. I haven’t heard how many people are on the wait-list. How do you determine how many appointments there are without setting a goal?

 

FRANCINE VEZINA: The number of appointments would be dependent on when we hit that point where we are able to offer appointments to everyone who calls within 28 days. The number that would be, I’m not sure, so that’s why the target is how long they would have to wait.

 

THE CHAIR: MLA Wilson with 40 seconds remaining.

 

ROD WILSON: Can you tell me - and I realize it changes - how many people are on the wait-list at this point for universal mental?

 

KIMBERLY STEWART: I don’t have the specific number, but we will get it for you. One thing I would like to make sure is clear as well is with the insured services program, people have a choice when they call. There are people who sometimes say no, they would prefer to wait and talk to someone in the public system. That is something we are finding in the work we’re doing, and it varies by region. The majority of people on the wait-list are being offered those appointments, and for a variety of reasons, they’re saying no.

 

THE CHAIR: Order. We’ll move on to the Liberal caucus with 12 minutes.

 

MLA Rankin.

 

IAIN RANKIN: I do want to talk about hospice a little bit. I just want to ask a question around - obviously, there are a lot of people waiting to access mental health supports and there’s a lot of effort that’s gone through successive governments to expand collaborative care centres. “Health homes” is the new term for it, but essentially different competencies in allied health being able to provide the appropriate care that someone may not need to see a physician for. Are there efforts in actually providing the mental health clinicians within those health homes, or even psychiatrists within those health homes, to take on some of those patients who are entering into those health homes and being attached?

 

THE CHAIR: ADM Stewart.

 

KIMBERLY STEWART: Yes, that is the intention. We are working, again, with the Department of Health and Wellness. There’s a group of people there who are working on the health homes and that work, and we are part of all those discussions. One of the things - again, I’m fairly new in this role. One of the things that really stood out to me is that mental health - it’s not like there’s health care and then there’s mental health care. It’s all together. It has to be part of it so when people come into emergency departments and they’re in crisis - if you have a heart attack, if you have a broken leg, it really does have to be integrated. It is really important to us and our office, and we’re working closely with the Department of Health and Wellness to make sure that is all integrated within those health homes.

 

IAIN RANKIN: That’s good to hear. I think there’s been a lot of advancement in the clinics around my area. It started with a doctor and now they have four doctors, a few nurse practitioners, some of them family practice nurses, but I think what’s missing is the mental health support, the dietitian support, the thing that we’ve been talking about for decades and just trying to get it done. Also, pharmacists want to be a big part of this. There has been credit to the government moving forward on scope expansion, and part of that was medication renewals.

 

As part of those medication renewals, are we talking with PANS about expanding those to those types of prescriptions that people are waiting for that we’re talking about today? They’re not attached, but can they go to a pharmacist? The Bloom Program has been operating for a long time. I know that’s a navigating tool within pharmacies, but they are the ones who know most about medications. Obviously, there are guardrails in terms of not increasing what they’re provided and safety around the actual prescription, but why not look at that opportunity to provide renewals for patients who really need it?

 

KIMBERLY STEWART: It is true - ensuring that Nova Scotians have the care they need when they need it, whether it’s a doctor, a pharmacist, or whomever the health professional is. We mentioned earlier about RASP - that’s the Rapid Access and Stabilization Program for psychiatry - that has been one way. Margaret mentioned that we are able, for those in crisis, to have their medications adjusted more quickly, but we take your point about looking into that with the pharmacists and we’ll take that back, MLA Rankin.

 

[2:30 p.m.]

 

IAIN RANKIN: I appreciate that. I just wanted to touch on hospices, because I did visit the Halifax location and saw the incredible services they offer. They do provide stuff, they cover grief support services, social work assistance, and other compassionate care, the music programs - all great. I don’t see them as a recipient of this Community Wellness Grant providing $750,000 over three years.

 

I met the staff, and one of them particularly spent a significant amount of time doing grant applications. My colleague spoke about a lot of the time that goes into that stuff. I just wonder: How do you qualify the recipients of this grant? Would an association like Hospice Halifax be eligible to cover some of those costs that are important for their clients?

 

THE CHAIR: Ms. Vezina.

 

FRANCINE VEZINA: The criteria for the Community Wellness Grant were based on several things. One of the domains would have been the determinants of health. In what way are the community organizations addressing the determinants of mental health within their project or initiative? We were looking across the province in terms of services that are available in different areas of the province, urban versus rural, et cetera. That was one of the criteria for the selection of the grants. Then we also looked at how proposals aligned with government priorities and what the government was trying to achieve through - primarily Action for Health and universal mental health and addictions. Those would have been the three main ways that they were evaluated for the grants.

 

IAIN RANKIN: There’s very limited access to hospice care in the province. My understanding is that - I don’t have the exact figure in front of me, but I’m sure Mr. Guest has it - the majority of people who are waiting to access care never get it. Because mental health for humans on their last days, it’s an incredible service that a lot of people don’t get access to. I just want to ask: In terms of the expansion opportunity specific to Dartmouth, there’s a proposal before the government to look at a 10- to 15-bed facility in Dartmouth, and I’m just wondering if the Office of Addictions and Mental Health is actively supporting that support service expansion on the Dartmouth side.

 

KIMBERLY STEWART: I will say that ensuring every Nova Scotian has the mental health support they need at the various stages of their life is at the core of what we are doing. I can’t speak specifically to the project you reference in Dartmouth regarding hospice. I don’t have any details on that, but it is an important area for sure.

 

IAIN RANKIN: My intent is to make sure it’s on your radar. That’s why I wanted to mention it today. Maybe I’ll ask Mr. Guest to speak a little bit more to the importance and the capacity we have in the province right now to meet the needs of the population. You probably know more about the specifics about the wait-list of folks waiting to access the services. Maybe I’ll ask a question: How many sites or beds would we need to fulfill the need and the demand that we have in Nova Scotia?

 

THE CHAIR: Mr. Guest.

 

TIM GUEST: I didn’t bring specific data associated with hospice today. I can tell you that Nova Scotians want access to a variety of options with respect to end-of-life care, whether it be hospice or whether it be supports to remain in their homes. I think whatever the strategy is, it needs to be considerate of all of those options available to them. I think it also varies with where the person lives. Hospice at this point in Nova Scotia is currently offered in Kentville, Sydney, and Halifax. People tend to not want to travel away from their social supports and their homes. They do want supports in the community to be able to remain home.

 

When you look at the CIHI comparison of hospice beds - palliative care and hospice beds per 100,000 population, Nova Scotia is on the lower side. I don’t have the specific number with me, but when you look at the comparison across the country, there is data to suggest that we do need more. But I can’t tell you the specific number.

 

IAIN RANKIN: Indeed, and I think Canada is on the lower side when you compare to, especially, the Scandinavian-type countries.

 

I want to ask the question, then, with the last couple of minutes, to you, Mr. Guest: What else can the government do to better support the aging population and families in preparation for palliative and end-of-life care?

 

TIM GUEST: Generally what we hear from individuals and families in the community is that it’s the supports that are needed for them to stay home. I think they vary across the province. We do hear that there are sometimes inconsistencies in the delivery of service from area to area, and I think some of that is historical, where it came from prior to the health system being transformed into the health authority, when there were the district health authorities - some of those historical practices are still in place.

 

As an example, I hear from southwest Nova Scotia that if you want to stay home with a pain pump, that’s more challenging than if you live around Antigonish, as an example, just because of how that service is supported. Some of what I hear is more consistency with access to some of those programs, to be able to have those options.

 

People want to stay as close to home as they can. That’s really the big factor that we hear from families and communities. They want the option to stay as close to their loved ones as possible, and many like to stay at home.

 

THE CHAIR: MLA Rankin with one and a half minutes remaining.

 

IAIN RANKIN: Yes, that’s not much time. But I think I want to end by saying that I want to support any project that helps expand that kind of service. It’s something that I think not a lot of Nova Scotians actually understand, but the facility is an outstanding one in Halifax - not on a bus route, though, and I think the Dartmouth location would be able to provide that, in terms of location, that Mr. Guest spoke of.

 

There are efforts across the province, especially given that 50 percent of the costs are fundraised. People really care about it. If government can help with that funding that communities are putting forward, I think that would be a worthwhile investment for Nova Scotians. I’ll end there.

 

THE CHAIR: We’ll move on to the PC caucus and we’ll start with MLA Corkum-Greek.

 

SUSAN CORKUM-GREEK: First of all, I want to thank - we were a little short for time, and people were really concise in terms of replying to my last question. I really appreciate that.

 

Another take-away from my time in nonprofits was how often I was trying to find a way to fit the program. I used to call this process “pretzel making.” I’d like to say I became a pretty good pretzel-maker, if I do say so - not 100-percent effective, but.

 

From the outside - this is the value of these committee opportunities to have you here to confirm or to set straight, but from the outside, what I liked about the project stream of the framework was its openness. Rather than having to be XYZ and fit those parameters, perhaps this allows those organizations applying for funding to be as nimble as possible to the very specific needs of their communities.

 

This was referenced a little bit earlier in a question to Ms. Cunningham about some of the trends that you’ve picked up on. If you can maybe just tell us a little bit more about the application process and that issue of - am I out to lunch on this? Is there that kind of flexibility of purpose for the organizations themselves?

 

THE CHAIR: Ms. Cunningham.

 

STARR CUNNINGHAM: Just a warning: I could talk about our grants process all day long. (Laughter) I won’t.

 

The great thing about our process is that we don’t tell communities or individuals or organizations what we think they need. They tell us what they need. We allow every organization that’s looking for funding support for a mental health and addictions program or project in their community to tell us what they need, why they need it, and who it’s going to help.

 

As far as the pretzel making, they’re not the twisty pretzels; they’re the ones that are straight sticks. We try to make it as simple as possible for the applicants to apply. I think that’s key because we have all different levels of organizations applying for funding. We have Kids Help Phone applying for funding, but then we also have an organization in Guysborough that’s run solely by volunteers, and they’re looking for a peer support program in a church basement, so our program has to be accessible to all.

 

I mentioned technology a little earlier too. Technology has allowed us to make a difference there. I see Marg shaking her head - so we provide CMHA with funding. We provide Hospice Halifax with funding. Our goal in investing in technology was to make it easier and more streamlined for organizations to apply, so they’re not wasting their time trying to cross all the t’s and dot all the i’s and make it the way we want it. We want to make it more universal. We’ve really made that a priority.

 

SUSAN CORKUM-GREEK: Thank you for confirming that. I can really, truly on a personal level appreciate every time that you can make something more effective and streamlined to simply get the intended support to those activities.

 

I also do recognize that evaluation of any government program, that we are obligated - it’s our duty to understand the value and the learnings because not everything that doesn’t work out is without value. I would revert to the department - if you can speak specifically to that evaluation process including, if you could, how that will also work as oversight to identify gaps geographically community-wise and so forth.

 

THE CHAIR: ADM Stewart.

 

KIMBERLY STEWART: With the Community Wellness Framework, accountability and the transparency is one of the key pillars of that. We’ve mentioned already the community liaison role. That is a key person in that work. The quarterly meetings - we have status reports, annual financial statements. That’s something we’ve done all along, but these quarterly check-ins and keeping our finger on the pulse, for lack of a better word, to really understand what’s going on in those communities with those organizations, that’s really a key way to understand the gaps, not just wait for the annual report to come in, but to have the ongoing conversation and the ongoing dialogue with the groups to understand their needs. That’s how we realized as well that the long-term funding is something that is helpful. We also have biannual expenditure reports and accountability reports that we do. That all feeds into that process.

 

We’ve said it a few times, but it’s really early days for this work. It’s been a big shift in how we are working in communities. We’re learning and we’ll adapt as we hear from communities. That first voice is really important to inform what we do, while also maintaining the right balance. We need the right balance of straight pretzels and the right balance of the rigour to ensure the money is being well-invested in achieving the outcomes we’re trying to get.

 

THE CHAIR: MLA Corkum-Greek with six minutes remaining.

 

SUSAN CORKUM-GREEK: Thank you. I will pass the remaining time to my colleague.

 

THE CHAIR: MLA Fadare.

 

ADEGOKE FADARE: Good afternoon. Thank you for coming here today. I think something’s very clear - we’re obviously moving in the right direction based on things I’m hearing today. I’m glad to hear Ms. Cunningham talking about the multi-year funding, how it has helped with technology because I was a community person myself. I served on different community organizations. I can’t count the number of grants I’ve had to apply for and the number of application forms that we needed to fill, but I’m excited to hear what I’m hearing today - that we’re presently supporting 23 community organizations with multi-year funding, which has never happened before. I think that’s significant progress. I heard about the calm and the ability to plan further as a result of that. So I think those are some of the major take-aways for me that I’m hearing today.

 

[2:45 p.m.]

 

I just want to ask quickly, because as a community person myself, I’m just wondering - we know that mental health has its own stigma within communities, right? How do community members or people residing in a particular community become aware of the services that are being provided locally? Obviously, one of the things that has been achieved through the Community Wellness Framework is to bring mental health care closer to the people. How do people know that you do have these opportunities? For example, a constituent comes to my door. How do I direct them? How do I tell them that this is where to go? Anyone from the community organizations can help me out here.

 

THE CHAIR: Ms. Murray.

 

MARGARET MURRAY: That’s an excellent question. If someone came to your door, certainly, it’s already been mentioned - I would suggest that if you’re not sure of the specific community you’re looking for, I’d suggest they contact 211. Also, the website that hasn’t been mentioned today that is with the Mental Health and Addictions program, a lot of people aren’t aware of that. That is something that I know for - many individuals in organizations a few years ago were actually invited to give input into that website. It’s the MHA - I can’t remember the exact name of it, but we can get that to you.

 

A lot of people don’t access that website, which not only lists all the clinical services in Mental Health and Addictions, the formal system, but also lists all the community agencies and different programs that are available, and certainly, all our local websites, CMHA. Really, 211 - people don’t realize that’s a place you can go and just often access any program. We receive - not just our local Halifax-Dartmouth Branch of the Canadian Mental Health Association but also our provincial office and Colchester-East Hants Branch and from southwest Nova Scotia, but particularly our branch locally, we receive thousands of calls each year where people are asking. Because of who we are, as the Canadian Mental Health Association, we don’t just offer programs; we will offer navigation. Oftentimes, we get calls because we’re known across the country.

 

I think for many of the organizations, you’ll find that even if the person doesn’t have the exact right number, I know organizations like ours will help a person access what they’re looking for. Sometimes people will call us in crisis. We have to give them the information on how to access services, and we will encourage them to reconnect with us a little bit down the road when they want to think about that. Those are some that I would suggest. I’ll defer to others here.

 

THE CHAIR: Mr. Guest.

 

TIM GUEST: Just a couple of things that I would highlight. One, part of our work each year that we plan for with our grant from the office is a public awareness campaign. This year, our focus was on increasing grief literacy in the general population to try to create more of an understanding that grief is a normal human process that we will all experience in our lives. We’re planning to do that again next year.

 

The second thing I would say is that we created an online database called Healing Pathways - Grieving Well. I gave you all a card on it. One of the nice things with the database is that it allows an individual to go on, answer a few questions about whether you want service that’s one-to-one, whether you’re okay with it in a group, whether you’re okay with it virtually, how far you’re willing to go. Then what it will do is actually filter the supports and resources for you so that it can tell you which ones are available close to you within the parameters that you’ve selected. There are 200 supports now provincially that we’ve got on the database, and it’s growing all the time.

 

One of the things we clearly heard from community, however - particularly in rural, isolated communities that don’t have the same access to broadband internet - is that they need the resources in a different way. So one of the things we’re looking at this year is putting out a print version that we can make available in those communities that are more isolated. Those are a couple of examples of what we’ve been trying to do to make people aware of the resources and supports, particularly on the grief side.

 

THE CHAIR: Ms. Cunningham, there are about 15 seconds left, sorry.

 

STARR CUNNINGHAM: Speedy. Just to touch on what Marg mentioned, 211 works very well for us too, and where we serve all of Nova Scotia and rural locations, people will call us looking for service. We’re fundraisers, but we help them by opening the 211 website from our desk and asking them the questions, and then providing them with the information. It sounds simple, but it works.

 

THE CHAIR: That’s the questions and answers over. Thank you all very much for that.

 

I’d ask the witnesses if anyone would like to provide closing remarks. ADM Stewart.

 

KIMBERLY STEWART: I just want to thank the Chair and all the participants today for welcoming us here. I was very happy to be here and welcomed the opportunity to highlight the vital role that the community organizations are playing in building universal access to mental health and addictions care here in Nova Scotia.

 

The organizations aren’t just filling gaps. They’re driving real change in our communities. They’re making more support available closer to home for Nova Scotians. They are part of helping government transform how we deliver care. This is a shift in approach. As we work with more partners and invest across the full spectrum of supports, from prevention and early intervention to acute services, our goal is to help people before they reach a crisis and to ensure compassionate, reliable care when and where it’s needed.

 

We can’t do it alone. That’s why we’re working with the skilled professionals at the Nova Scotia universities, in the colleges, the public and private health care system, and as we heard today, with our community organizations. We’re proud of the progress we’ve made so far, and we are committed to expanding the support options that make a difference for those in what matters most.

 

Thank you to everyone working in this space across the province in mental health and addictions. We’re changing how we deliver mental health support. It takes time and we’re making progress, but there is more work ahead. Nova Scotians can rest assured that we will continue to evaluate, learn, and adapt as we move forward together.

 

THE CHAIR: Would anyone else like to provide closing remarks?

 

Hearing none, I’d like to thank the witnesses for being here today - a very informative session.

 

Seeing no committee business, the next meeting is February 10th at 1:00 p.m. here in the Committee Room. The topic is Early Years Programs from Public Health and the witness will be the Nova Scotia Health Authority.

 

Thank you all very much. The meeting is adjourned.

 

[The committee adjourned at 2:52 p.m.]