Indigenous and Northern Affairs Committee on June 5th, 2018

[Jeff Anderson]

I would like to back up what the chief is saying, complementing it by saying that a lot of hard work was done and that there's more hard work to go. As Natalie was saying, however, we are still just volunteers. I'm not a doctor. I'm not a nurse. I'm not a statistician. We are just a passionate group of people who know that we have a dire need now, let alone in 2036—or 2031, depending on which dataset you're looking at. If we don't start getting ahead of this now, you're going to have a bigger issue in the future and we really want your help.

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

Yes.

I was just part of another study in another committee that was talking about a national seniors strategy and about our needing to start planning, because this population is growing. Indigenous populations were identified as among the most vulnerable populations.

Could you share with me a little bit, as a person who also represents a really remote and rural riding, what the benefits are? I really appreciate the point about the nine-hour drive. I think that's really important to point out. I think that sometimes people sitting in Ottawa don't understand the realities of rural communities and how important it is that we find creative solutions, which I feel you're working on, to create care facilities that will keep people closer to home.

Could you talk a bit about what the challenges are, for you as a group of volunteers trying to move this forward, and how the federal government could do a better job of being more receptive?

Go ahead, Jeff.

[Jeff Anderson]

I'm toggling through my mind to decide where to start.

I'll give you a quick little testimony. We have a lady who's very near and dear to us, Marguerite Peecheemow. She's in her mid-eighties. She grew up in Fox Lake. That's one of those communities you have to barge across or fly across to, or wait for the winter road to be built.

She was at the long-term care facility in La Crete, which distanced her by about three or four hours from her core family and friendship group. Because of, if I can be so bold as to say so, a lack of cultural inclusivity, many of us would travel to La Crete to spend time with her in lieu of her family, who were not able to make it because of economic conditions and problems of accessibility.

I'll say it this way. She gracefully broke her hip, and they had to move her into Fort Vermilion. She is actually much happier, because she is a bit closer to her family.

The broken hip came because of overstuffed facilities, according to her testimony, and people not being able to really get to her and look after her. As I said earlier, we have staff shortages. One of our three recommendations is to look at how we can bring more education and training into the area. It's a kind of cumulative effect that has caused people such as Mrs. Peecheemow to sustain hip injuries.

I was talking to one of her family members just a couple of weeks ago. They would love nothing more than to be much closer to Marguerite. The reality is that many first nations might not even have a car, and to be able to see their family, even from two or three hours away let alone nine hours away, can sometimes be an impossibility. In talking to this person, I found they hadn't seen their own mom for two and a half years, and that's just within the region, let alone considering cases out of the region.

I don't know how else to say it to you. I know I'm getting caught up in the passionate anecdotal type of stuff here, but that's what I would like to share on that, Rachel.

[The Chair, Liberal, MaryAnn Mihychuk]

Good.

We have to move on to another MP, and that is MP Robert Ouellette.

[Robert-Falcon Ouellette, Liberal, Winnipeg Centre, MB]

Tansi. Thank you very much for coming. I appreciate the opportunity to hear you give your testimony.

I wonder whether we could talk a little more about training. I was working at the University of Manitoba as a professor before, and we were looking at setting up something related to this: elder care in first nations communities.

What are the qualification levels and the difficulties you face in finding qualified individuals who not only have training in a health care profession but also have an understanding of indigenous communities and are willing to remain for extended periods of time and live in and be part of the community?

That's a general question for everyone.

[Natalie Gibson]

It has to tie to any continuum of care. Within northern Alberta it's called the north zone. There is a program that was initiated by the regional director, called Grow Your Own, because it was so difficult to get staff or even train staff, even at a health aide or health certification LPN/RN level. Even the more mature students could start part of their training within the region and then had to finish off in the municipality of Grande Prairie, which is four hours to the south. They had to leave their families to finish this, so quite often the apprenticeship programs were not completed.

Grow Your Own was started up, and Northlands College was the partner in that as well. They're trying to work through those solutions, but there are still a lot of gaps. As Jeff mentioned, two RN positions have been posted for two full years and nobody has filled them. In addition to that, there are support services whose specialists fly in and out of the region and are not housed within it on a regular basis, so you may have to wait 30 days for an appointment.

[Robert-Falcon Ouellette, Liberal, Winnipeg Centre, MB]

You also just need health care aides sometimes.

[Natalie Gibson]

Yes, definitely.

Chief Meneen and the group have spoken about looking at the options for more training on reserve and on settlement within the region to tie to that. The health care aides could assist people to stay in their homes longer. As you noted, a very critical part of any type of long-term care is that it allows seniors and elders to stay in their homes longer.

We were talking on the flight out about the doctors at St. Theresa General Hospital. They are from South Africa, and they fly in and fly out. There are four individuals who shift off, so they are not actually from the community or the region as a whole. They can set the agenda as to what does or doesn't occur in the region sometimes.

[Robert-Falcon Ouellette, Liberal, Winnipeg Centre, MB]

Chief Meneen, do you have comments about the training requirements for your community in Fort Vermilion, Alberta?

[Chief Rupert Meneen]

Yes, it is important that we train our own people, because obviously we're looking at culturally inclusive facilities. You're going to have to be able to speak Dene and Cree. Having our own people, if there is a job waiting for them.... The problem in our area is that our kids go off to school. They get educated and there is no job waiting for them in our area because there is nothing here, so they all end up leaving to go to work somewhere else.

We have been in talks with Alberta Health Services, and our local MLA, Danielle Larivee, has also been supportive of having some sort of training program to be able to house our trainees and put them to work in this facility.

I have graduates next week, and if I were to go to that school and say that I have a job but I want them to take this training at this school for however many years it's going to take to be able to put them to work here, where they could take care of our grandparents—our elders—I think we would have an influx of people coming from all of our region to take care of our elders.

[Robert-Falcon Ouellette, Liberal, Winnipeg Centre, MB]

You wouldn't need to fly people in from outside to look after them.

I was also wondering if you could talk a bit about the funding arrangements that are necessary in order to see success in elder care, so that there are reduced costs, we don't have to send people outside of their communities, and they can actually remain at home with their families in a continuum of life and care. Perhaps you could outline how much is needed from the federal government, how much from the province, and then how much from the local community.

How should people actually be working together on these funding arrangements?

[Chief Rupert Meneen]

We could do it equally between the federal government, Alberta Health Services, and the province. The province has been really open to any conversation we have had with them, and they're really willing to work with first nations right now. I could put a proposal in front of them and say, “This is what it's going to cost. Can you pony up one-quarter or one-half or whatever it is to train people to be able to put them in a facility?” I think they would be totally open to that, and I don't think the price of that would scare anybody.

[Robert-Falcon Ouellette, Liberal, Winnipeg Centre, MB]

Ms. Gibson, and then Mr. Boese.

[Natalie Gibson]

There are different models for consideration as well. The study that was done in 2014 has valid data that should have been used and never moved ahead. It indicated that almost 35% of the population is low income, and that includes low-income seniors. Looking at ways of staging the levels of income support and how that support is garnered within the region, the opportunity for consideration of research needs to look at those socio-economic conditions.

There are also other models within Alberta and the country. Housing as a Business, HaaB, has created a model where housing is the focus of the project, but you can start a landscaping company, or a deck-building, painting, or roofing company that goes with it, so there is revenue generation as well.

That type of model is the type of model we looked at to ask what there can be when we look at sustainability and employment opportunities, and when we build capacity. Sometimes the statistics for the indigenous population in terms of completion of some of these programs is not the best, and it could be due to not having a driver's licence or due to other conditions. All of these are considerations, not only for a long-term lodge but for a facility itself.

[The Chair, Liberal, MaryAnn Mihychuk]

Questioning now moves to MP Cathy McLeod.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Thank you to all the witnesses, and congratulations on coming together to do what needs to be done for your community.

I tend to believe the federal government should try to be more responsive to community-led solutions. We simply should have some goals. Sometimes square pegs in round holes don't fit that well. If we set some standards around what our goals are and then let the creativity and the flexibility flow, I think that is something we could maybe consider as we talk about what this report will look like.

Someone said it's time to do something. My question is, do what? You said you've been at a standstill. What is the next step that you see you need to do?

[Jeff Anderson]

I'll take that one.

I know you don't have the notes in front of you yet, but just to reiterate what Mr. Boese brought up, we see that the next steps are our three recommendations: establish the northern metrics, develop a culturally inclusive business case for the facility, and start looking at building capacity in the health care workforce up north here.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Do you actually have land set aside for the facility? Do you have conceptual drawings? Are you at the stage of detailed drawings?

[Jeff Anderson]

Yes, we have land that's been set aside; however, we haven't gotten to the level yet of any kind of conceptual drawings and whatnot. We still would like to work out the data to find out exactly what the need is, and what the future need would be, so that design would be more of a long-term focus and not just a short-term gain.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

I know in British Columbia it was a bit of a different scenario, but I know through what we call B.C. Housing, and maybe through CMHC, they have funding streams to do those next steps in terms of the more in-depth analysis, which is more than just volunteers can do. Is that a path you've headed down yet?

[Jeff Anderson]

We are certainly circling around that. CMHC is part of the strategic task force that we currently have with departments from the province and the federal government. We actually meet again tomorrow, and CMHC is at the table, but we have not dove into exactly what they're going to bring yet.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

I know an initiative in the area I represent was the seed planning money, which really set them into the next step.

I see Natalie wants to jump in here.

[Natalie Gibson]

I'd like to add a little more about the task force. The task force started from meetings we had with INAC, employment services in Ottawa, and the ministers of health and indigenous relations in Alberta. It was discussed amongst this group that the task force needs different departments.

In Alberta we have Alberta Seniors and Housing, which is funded by CMHC. We've had three conference calls since then, getting the various groups into the room to see whose portfolio we're supposed to speak to. Alberta Health Services sent us to Health Canada, which sent us to Alberta Seniors and Housing. Now we have the group in the room discussing whose mandate it is.

It's very interesting to watch it unfold, because we're still not sure, nor are they. The task force is in a preliminary stage of “What next?” It's exciting that we had 36 individuals on the phone last time. Chief Meneen is really good at encouraging us: “What was the outcome?” “It was a good call.” “What was the outcome?”

We're still not there yet. In your meeting 109, we heard Mr. Conn speak about the 100 recipients of pilot projects. We'd like to be one of those, please. We'll add that as a recommendation.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

In terms of the other programs that are related to supporting seniors or elders in care, right now the streams are very different, so you probably have the Alberta Health Services providing some for the off reserve and—

[The Chair, Liberal, MaryAnn Mihychuk]

It will have to be a yes or no answer, because we've run out of time.