Indigenous and Northern Affairs Committee on May 31st, 2018

[Grand Chief Joel Abram, Grand Chief, Association of Iroquois and Allied Indians]

Shekoli swakweku, everybody. I'm from the Oneida Nation of the Thames. I was the elected chief from 2008 to 2014. During that time we built a long-term care facility. That was the first one in Ontario in over 25 years, since Akwesasne was awarded some bids. I can speak to some of the difficulties we had in building the facility. At the end of the day all I can say is thank God for the recession in 2008 and some stimulus dollars. First nations are pretty much in a constant recession/depression mode. We were able to get some money out of FedDev, but until that point no place in government would support that. Even INAC said they didn't have any dollars specifically for long-term care facilities. Their priority is on other areas. I don't know about drinking water, considering the situation, but there's just not enough capital.

As for employment and training, we have about 6,000 members, about 2,400 on reserve. We started the training around the same time as the construction was going on. We had start-up programs for PSWs utilizing our employment and training dollars, and also encouraging people to go into RPN and the health programs, those sorts of things. Right now we have around 70 full- and part-time positions through PSWs. We have RPNs, administration, maintenance, the whole gamut. Maybe 60% to 70% are first nations employees. They're not all from Oneida. Some are from neighbouring first nations, some are non-first nations. Our residents are also Oneida and also from local first nations in the southwest region and from the general population as well. We have a combination.

You have to take some initiatives and do some things early on in the staffing process to make sure you build up your human resources to do that. There were a lot of roadblocks.

[The Chair, Liberal, MaryAnn Mihychuk]

Thank you.

Questioning now moves to MP Rachel Blaney. You have seven minutes

[Rachel Blaney, NDP, North Island—Powell River, BC]

Thank you all for being here with us today.

Chief Maracle, could you tell us a little about how your community disburses the federal funding for long-term care? Is there provincial funding as well? Have you had any trouble reconciling the funding?

[Chief R. Donald Maracle]

It's a 128-bed licence. The province will provide a per bed per capita subsidy of $17.55 per day. It could go up to as high as $18. That would generate about $12 million from the Government of Ontario. The long-term care facility will cost $28.2 million to build, so we're looking for about $15 million.

[Rachel Blaney, NDP, North Island—Powell River, BC]

Okay, thank you.

[Chief R. Donald Maracle]

The problem with Indian Affairs is how they define housing. To me, a house is a roof over your head, a place where you eat and sleep. Whether it's a long-term care facility or a bungalow or an apartment, it's still a shelter. The long-term care part is the services provided: nursing care, PSW, meal preparation, bathing. It could be a combination of them, and a different view of what housing is, then I think maybe some money could come from housing, from Indian Affairs, to build the long-term care facility, because people live there.

[Rachel Blaney, NDP, North Island—Powell River, BC]

I represent a very rural riding, with over 20 indigenous communities. One of the challenges is they're very remote and very small; they're trying to figure out where they're going to send their elders, who are very unhappy.

I think the other part that's so important about this is if we have any dementia in our communities, they often lose their English in some cases, and so they're going somewhere where they don't get the support.

You said you've seen an increase in funding, but the issues are still the same. Can you talk to us about why?

[Chief R. Donald Maracle]

There's an increase in home support funding, which means the personal support workers and the nurses go to the home and provide care, but a chronic number of people can't find affordable housing, and they are seniors who are vulnerable, who are at risk. Often when their health deteriorates to the point where there are chronic falls or they start to lose their eyesight or they get gangrene and they have to have amputations or the spouse dies, with a lower income, they can't afford the occupancy cost, plus they have a multitude of health issues and frailty combined, so they can't live on their own. Then when you try to find a place in a long-term care facility, you might wait two years. Or if there's Alzheimer's disease, they're at risk of wandering and drowning and all this sort of thing because there's no one to stay with them. The home care does not provide 24-hour care. The maximum they get is four hours a day.

[Rachel Blaney, NDP, North Island—Powell River, BC]

Yes, which is a huge—

[Chief R. Donald Maracle]

When people progress and need care beyond that level, the only alternative is a long-term care facility.

[Rachel Blaney, NDP, North Island—Powell River, BC]

Then you have the challenge of seeing if you can find one that will be able to take them.

[Chief R. Donald Maracle]

There aren't any. Really, our community would be out of luck. There's no place. The people who are the most frail and most vulnerable have nowhere to go. These are the people who built the roads. They built the hospitals. They've been employed in every occupation. The only thing that this country can say to them when they are the most frail and in the most need of help is that there's no place for them to go.

[Rachel Blaney, NDP, North Island—Powell River, BC]

We just finished a report on a national seniors strategy. We heard again and again that indigenous communities are one of the most vulnerable senior and aging communities and that this needed to be looked at. One of the things that came up in that report was the lack of data that's collected.

Could you talk to me a little bit about what your community is doing? Do you see the data collection that is needed to measure and look at the issues that are arising?

[Chief R. Donald Maracle]

When people apply to go into a long-term-care home, if they could say whether they have access to non-insured health benefits, that would prove that they are a status Indian. But there's no data collected like that in any of the 14 men's.... It's based on what the community knows. We have almost 8,000 people living off-reserve. Some of them are 3,000.... Nobody knows what their health is until they come wanting a place. We get calls quite often at the office to help them find someplace for their loved one to be, and there isn't any.

[Rachel Blaney, NDP, North Island—Powell River, BC]

You talked about being jurisdictionally jumbled. Can you just tell us a little bit of what you mean by that?

[Chief R. Donald Maracle]

One example is that FedDev should exist to create jobs, long-term jobs. That should be the ultimate goal of the FedDev. Yet they will say they might be able to buy some of the equipment for that place but that would be about the extent of it. With the CORP application, the criteria's still a little bit different. You might get $1 million, or you might get $3 million.

Through Trenval, you might get $250,000. There are various pots of money here and there. If it was coordinated, it would actually help the first nations do better planning and get the projects off the ground a lot faster than if they have to shop around for money.

The federal government needs to have a coordinated approach for essential services, like health care and long-term care. If they created a partnership with the province.... I don't say they should give all the money to the province and let them decide where it's going to go. The federal government needs to have some deliverables attached to the money they hand over to the provinces. The need right now is for capital. The biggest issue in Ontario is capital for projects—for housing, roads, water, long-term care.

[Rachel Blaney, NDP, North Island—Powell River, BC]

Absolutely.

One of the things you also talked about was the challenges of folks on- and off-reserve. If they live close to the community, they're coming to try to access services on reserve. Of course, they don't necessarily fit in the formula. I'm wondering if you could talk a little bit about those challenges and how you've been creative in addressing them.

[Chief R. Donald Maracle]

A lot of that is federally imposed. It's not imposed by the first nations. Some of their programs and services are designed for people who live on the reserve. The waiting list is usually made up of people who don't live on the reserve but want to live on the reserve. I gave you a list of the housing criteria to show the number of people who are pounding on our door wanting to live on the reserve. We have to acquire some capital from Canada to correct these issues.

[Rachel Blaney, NDP, North Island—Powell River, BC]

I'm wondering if you have any insight as to why people who are close to the reserve but living off reserve don't feel comfortable accessing services in the other communities.

[Chief R. Donald Maracle]

They are not available, for one thing. There's a shortage of affordable housing in nearly every municipality. Oftentimes they're coming to the reserve to see if there's affordable housing only to find that there's a long waiting list. It's really that there's no place for them to turn.

The other thing is that people want to come home. They grew up there. They have family that live there. They want to come home. They've retired. They've worked. Not only were some of these people residential school survivors; a lot of them were veterans who took up arms in the Second World War and other wars as well as serving in peacekeeping times. Now that they are frail, the only answer we have is that there's nothing for them.

[The Chair, Liberal, MaryAnn Mihychuk]

Thank you.

We're going to conclude the round of questioning with MP Gary Anandasangaree.

[Gary Anandasangaree, Liberal, Scarborough—Rouge Park, ON]

Madam Chair, I'm going to yield my time to MP Bossio.

[Mike Bossio, Liberal, Hastings—Lennox and Addington, ON]

Thank you, my great colleague Mr. Anandasangaree.

Chief, once again, I'd like to go to the reality of the situation that exists within the Mohawks of the Bay of Quinte. We talked a bit about epidemiological data that exists, but it only exists through the Canadian community health survey. There are no data points that give a clear picture of the true need that exists within indigenous communities.

The Mohawks of the Bay of Quinte are a very sophisticated indigenous community, from a governance and administrative standpoint, and you have a far better handle on what is happening within your community than most would. It might be useful to look at your own community and the data points you think would be beneficial to you and then compare them to the needs that exist in other communities that aren't as well managed as yours.

[Chief R. Donald Maracle]

In terms of data, a lot of our band members have graduated from nursing school. They are licensed nurses, RPNs, and RNAs, and all that. As one of the data points, there's a report there from the nurse who actually visits the people who receive care. The people also have relatives; and we know, from talking with the families, what the needs of their families are. There is no formal way of collecting data right now, and that's what there needs to be, some formal way of collecting data.

[Mike Bossio, Liberal, Hastings—Lennox and Addington, ON]

You're in charge of a—