Health authority records first annual surplus but $296M deficit remains

For the first time since being created a decade ago, the NWT’s health authority has recorded an operating surplus thanks to staff vacancies and a one-time federal payment.

“There is cause for celebration here, but cautious,” said Dan Florizone, the territorial health authority’s public administrator, at its annual general meeting on Wednesday evening.

“The real celebration will occur when all our staffing lines are filled, when we’ve got sustainable and predictable funding, and where that budget is balanced.”

The authority, also referred to as NTHSSA, received an extra $30 million from the GNWT and $15.6 million from the federal government in 2025-26. Those increases, paired with vacant positions and less demand for medical travel, meant the authority ended 2025-26 with a $4.7-million operating surplus.

That means NTHSSA’s accumulated deficit over the years is now $296.1 million, down slightly from $300.8 million in 2024-25.

“Our goal is to staff 100 percent of our frontline services. We don’t hold any frontline vacancies that are service delivery for any administrative savings or anything like that,” said Kim Riles, NTHSSA’s chief executive officer.

“The reality is that, like every health and social service organization across the country, [full staffing] is not always possible for us. What that means is at times, we end up using options that could actually drive costs,” Riles said, describing those options as the likes of using more casual staff, which can mean an increase in travel and overtime costs.

The health authority has a longer-term target of delivering a balanced budget for the 2027-28 fiscal year, which may be a challenge despite this year’s surplus.

Florizone said achieving that will take “both a recognition of what we need to be right-funded and how we need to be right-funded.”

“I think we’re in a better position now than we’ve ever been. I think it’s achievable. I honestly believe it’s achievable,” said Florizone.

For 2026-27, the NTHSSA is back to a budgeted deficit of $20.5 million. In its 2025-26 annual report, the authority said it was taking various steps to try to end the current year in a better financial position, while advocating for more funding from the Department of Health and Social Services.

“We continue to make sure we’re refining things like our procurement, our monitoring and management of various controllable areas of expense. But fundamentally, there are areas where our funding does not match what we know our demand is going to be,” said Riles.

Riles said if NTHSSA does staff all positions next fiscal year, the health agency would be “back in a deficit position” because programs have been underfunded, in the authority’s view, since its formation in 2016.

‘We actually have made investments’

In April this year, NTHSSA rolled out a medical travel case management pilot program in Yellowknife. Florizone said funding has also been received to trial the program in the Beaufort Delta, which has had the highest demand for medical travel since 2021-22.

In 2025-26, medical travel in the Beaufort Delta was used 8,123 times. The Yellowknife region – the next highest – recorded 3,762 cases, according to NTHSSA’s performance indicators dashboard. Riles said the difference is the Beaufort Delta’s reliance on medical travel for dental care and the way local flight schedules operate.

The new case managers review medical travel requests to see if virtual care could be an option instead, help to group medical appointments for people travelling out of the territory, and search for options closer to their community, Florizone said.

The Yellowknife region is “seeing some early opportunities just from the initial implementation, and we’re far too early into this to be able to report on any outcomes. But certainly, we’re seeing some promise very early on,” said Riles.

Overall, Riles said, demand for medical travel only increased by two percent rather than the budgeted eight percent, excluding dental travel.

NTHSSA has also tried to offer more virtual care in Dehcho communities only served by a health cabin.

“This past year, we actually have made investments,” said Florizone.

Changes made in the Dehcho have been expanded to communities relying on health cabins in other regions, Riles said, and additional training provided is now available online for all NTHSSA employees.

Another 52 initiatives coming soon

In July, NTHSSA celebrated the end of a “52 Improvements in 52 Weeks” pilot project, which trialled a different staff-led initiative every week for a year.

Riles said she doesn’t know how many of the 52 initiatives continued after their initial week, but she gave examples of some expanded to other regions because of their success, like one to improve long-term care for patients with disabilities.

Florizone said another year of 52 staff-led initiatives is expected to launch in September, with a focus on increasing providers’ time with patients by “releasing time” from administrative work.

“When we look at efficiency,” said Florizone, “you want to actually be in front of your clients and patients, and not busy looking for things, filling out forms, trying to complete a process or contacting people.”

NTHSSA marks its 10th anniversary this year, a period that Riles said “has not been an easy era for healthcare in Canada or in the NWT.”

“We have navigated a pandemic, faced unprecedented climate emergencies, surging costs of goods and services, and we continue to face the most serious workforce shortages that the country has ever seen,” she said. “But all of these events have highlighted the strength of collectivity. Our system is stronger when we work together.”

Florizone also highlighted the need for collaboration among health authority employees.

“I think we’re on a path here, and it’s a positive one,” said Florizone.

“We need to remain diligent and remain focused. There’s a lot more improvements that are ahead of us that need to be made, and I witnessed a team that’s highly committed to doing that.”