Thank you very much, Mr. Chair.
I would like to thank you all for inviting me to appear before this committee on the issue of COVID-19. I want to begin by acknowledging that I am on the traditional territory of the Algonquin people, and I am here today, along with my colleagues, to discuss the unique strengths and challenges faced by first nations, Inuit and Métis in preparing for and responding to COVID-19.
First nations, Inuit and Métis know their communities and their community members. They know what will work and what will not work. The effectiveness of the government's response to COVID-19 among indigenous peoples relies on our ability to listen and provide support, tools, resources and reliable and timely information communicated in a culturally informed way.
The challenges faced today by indigenous peoples are related to poor social determinants of health and higher rates of respiratory and chronic disease. These challenges are well documented in countless detailed studies, including the Royal Commission on Aboriginal Peoples, the Truth and Reconciliation Commission, and the missing and murdered indigenous women and girls inquiry. These challenges are highly relevant to the COVID-19 planning and response required.
Lessons learned from H1N1 demonstrate the importance of connecting health to the social determinants of health in pandemic planning. The establishment of Indigenous Services Canada has strengthened the government's ability to focus its efforts, aligning the public health response with supports in social programs, critical infrastructure and broader emergency management. Investing in pandemic planning capacity and readiness across communities was also an important lesson learned.
With budget 2019 resources of $79.9 million over five years, Indigenous Services Canada proactively invested in first nations' capacity at the regional, tribal council and community levels in health emergency preparedness. The department also established a public health emergency network made up of regional medical officers and regional coordinators, including in emergency management, environmental public health and communicable disease emergency coordinators, to advise and support first nations across provinces.
While this capacity provided an important foundation, the need for communities and the department to adapt broad pandemic plans to the unique context of COVID-19 requires additional support and resources. It is also equally important to recognize the need to expand the support to first nations in the territories, Inuit, Métis, self-governing nations, indigenous individuals living away from their communities and indigenous communities within urban centres.
This is why the Government of Canada invested $305 million in the distinctions-based indigenous community support fund. These funds are provided to communities while maximizing their flexibility to respond to the immediate needs of their members. They include an urban and regional indigenous organization envelope of $15 million. Some of the needs being addressed through the community support fund are food subsidies for households; supports to control non-essential travel in communities; surge capacity costs for staff, critical equipment and supplies; and mental health supports.
In addition to the indigenous community support fund, the department is working with other federal colleagues to ensure that first nations, Inuit and Métis individuals can access the broader COVID-19 economic response plan benefits available to workers, families and businesses. Ten million dollars will be provided to Indigenous Services Canada's existing network of 46 emergency shelters, located on reserve and in Yukon, to support indigenous women and children fleeing violence. Approximately 329 first nations communities have been served by Indigenous Services Canada's funded emergency shelters.
On April 18, the Government of Canada announced up to $306.8 million in funding to help small and medium-sized indigenous businesses and to support aboriginal financial institutions that offer financing to these businesses. These measures will help 6,000 indigenous-owned businesses get through these difficult times and play a key role in the country's economic recovery.
Economic prosperity is an important determinant of health, particularly when you consider the younger age distribution among indigenous peoples.
In terms of my department's specific public health measures, I wish to highlight some of the core elements and activities of the response to date. While the exposure and number of confirmed cases among first nations and Inuit to date have been relatively limited, 0.01% of the total first nations on-reserve population compared to 0.09% for the rest of the population, vigilance is essential as the numbers are gradually increasing.
Communications and protocols have been critical, with multiple visual and social media channels being utilized and a heavy emphasis on adapting national public health guidance to target community priorities, including physical distancing, limits to non-essential travel, personal protective equipment, home and community care, long-term care and nursing homes on reserve, non-insured health benefits medical transportation, self-screening of health providers and visitors, access to testing and funerals.
As an example, we are supporting indigenous communities to implement adapted culturally relevant public health measures to promote physical distancing on the land. Translation of materials in indigenous languages will also continue.
At a national level, weekly briefings are taking place with the Assembly of First Nations chiefs committee on health, the Inuit public health task group and representatives of the Métis Nation. We are working closely with indigenous, federal, provincial and territorial partners through the public health working group on remote and isolated communities to ensure that the unique needs of these communities are met and that adequate preparedness, supplies and response levels are in place.
Weekly "touch bases" have also taken place with the National Association of Friendship Centres and the First Nations Health Managers Association. The department is also keeping apprised members of the indigenous women's well-being advisory committee, co-chaired by the National Aboriginal Council of Midwives and Pauktuutit.
At a regional level, our regional officials have either daily or multiple weekly calls with indigenous partners and work on a daily basis with provincial and territorial colleagues. As you know, health care is a shared jurisdiction, which raises the significance of coordination and collaboration among first nations, Inuit or Métis-led services with those of Indigenous Services Canada, other federal departments, provincial or territorial governments and their public health authorities.
During this pandemic, clarity of roles and responsibilities can remain a challenge, but thankfully, regional offices have spent recent years strengthening trilateral partnership tables. Relationships are well established and a strong asset in this COVID-19 response.
Indigenous Services Canada plays a more direct role for primary health care in 79 remote first nations communities and for public health among first nations on reserve across provinces, with the exception of British Columbia where the department acts as a funding and governance partner with the B.C. First Nations Health Authority.
Specifically, the department has mobilized its national health emergency network and regional command centres to actively support communities in updating testing and activating their pandemic or their all-hazards emergency plans. It has assessed more than 550 requests to the department stockpile for personal protective equipment and hand sanitizer, within 24 hours, intended for first nations health care workers. It has set up emergency contracts for surge nursing and paramedic capacity available to first nations health and long-term care facilities across provinces and identified additional physicians for the Society of Rural Physicians of Canada. It has worked with the Public Health Agency of Canada on the availability of swab tests, where these cannot be provided by provinces, and point-of-care testing in and/or near indigenous communities when those become available.
With fewer commercial flights and travel restrictions in place, the department has secured stable means to transport health professionals and needed supplies to remote first nations communities. Finally, we have directly purchased or funded alternative infrastructure for medical purposes or for accommodation. With a focus on remote communities, retooling existing space in schools, band offices or hotels is the preferred and fastest option. However, where this has been deemed impossible, 41 mobile medical units and 17 multi-purpose mobile trailers have been secured so far.
I understand the committee has been provided a copy of a dashboard we developed to provide to the committee some key information as it relates to COVID-19 and indigenous communities.
Indigenous Services Canada is also ensuring that additional supports are available through the emergency management assistance program, income assistance, non-insured health benefits, Jordan's principle, the Inuit child first initiative, and first nations child and family services.
When Indigenous Services Canada is made aware of COVID-19 tested positive cases, we work in collaboration with key partners to ensure appropriate health care is available for affected individuals; to implement immediate measures to reduce further community spread including contact tracing; and to identify any additional support that may be required. The health and safety of community members is a top priority, as is the need to respect the privacy of those who are sick with COVID-19.
With flood and fire season approaching, I want to assure you that the department is working closely with first nation communities to prevent any additional challenges that seasonal flooding and other natural disaster emergency situations may present in the midst of responding to the COVID-19 pandemic.
We are working to ensure that emergency seasonal evacuations continue to happen within the context of COVID-19. Confirmed and presumptive cases of COVID-19 will be assessed and treated using appropriate public health and primary care measures. Infection prevention and control measures are put into place to ensure that community members who are being evacuated are protected from being exposed to COVID-19.
We are learning and adapting quickly as the COVID-19 pandemic evolves. Currently, we are focused on enhancing our response efforts in key areas. We are partnering with indigenous organizations to ramp up and tailor communications to their needs, including youth, urban-based and northern populations.
We are working collaboratively with first nations on ensuring access to mental health resources, including virtual counselling, crisis lines surge capacity and strategies to cope with alcohol, opioid and methamphetamine addictions.