Indigenous and Northern Affairs Committee on June 7th, 2018

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

As part of this mobile unit team, there's a lot of infrastructure that needs to be in place in the individual communities so that these teams can even just deliver the services in the first place. In your view, how could long-term funding arrangements lift barriers related to first nations communities' capacity to provide long-term services and facilities? How could long-term funding arrangements offer first nations communities greater flexibility and autonomy in providing relevant long-term care services?

[The Chair, Liberal, MaryAnn Mihychuk]

To whom are you directing the question? We have someone on video conference.

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

To James once again, just because we have familiarity, with the experience of having visited there, with what's going on.

[John Cutfeet]

Again I'd go back to that health facility that was approved at Kitchenuhmaykoosib Inninuwug, Big Trout Lake. One question I raised was how we could include the province and how we could get provincial capital to come onside, so that we could have a bigger facility and accommodate provincial and federal programming.

The two capital processes do not coincide with one another. There needs to be some kind of discussion by the two levels of government to have that happen. Even if it's a one-off federal conversation for funding, for capital, they'll say, “That's the province's responsibility. We will not entertain that.” There needs to be a collaborative discussion between the two levels of government to see how we can merge the financial capital together so that better facilities can be built in first nations communities.

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

Thank you very much.

[The Chair, Liberal, MaryAnn Mihychuk]

Questioning moves now to Arnold Viersen and Kevin Waugh.

[Kevin Waugh, Conservative, Saskatoon—Grasswood, SK]

Okay, here we go.

I'm going to go off on yours. I would see three levels. I would see the federal, the provincial, and your community. When you talk about health care, you talk about nothing but waste in this country. I've just come from the province of Saskatchewan where we ditched 32 vice-presidents of whatever. We've gone to one health authority in my province. We used to have 32. We're down to one. They scrapped all the vice-presidents.

We've just had an interesting conversation with Chief Bellegarde on this. Let's start with the amount of money that is being wasted provincially, and I would say federally in administration that doesn't get to where it needs to go.

I'm going to, first of all, go to the Nishnawbe because you did talk about the federal government and the provincial government but I would say they should also include your group. I don't know where this conversation has to start on partnerships, but it's one that this country (a) cannot afford, and (b) must move very quickly on, because long-term care, whether it's in an urban resource, in an urban facility, or a reserve, is deplorable in this country.

Start with that, if you don't mind.

[John Cutfeet]

One thing that goes on in first nations communities to try to accommodate elder care is that first nations do seek financial resources to build facilities. What you're saying is, yes, there's the federal government, there's the province, and where's the first nation, that we can use the meagre resources we have to partner-up to build a better facility.

It's like my home community of Kitchenuhmaykoosib Inninuwug. They've amortized senior facilities to make sure that they have at least a place where they can accommodate seniors.

[Kevin Waugh, Conservative, Saskatoon—Grasswood, SK]

Yes. Good.

I have to go to Cadmus. Good to see you again, Cadmus. I want to congratulate you on all the work that you have done in your community since you've become chief. You've done a wonderful job on education and you have great ideas for your elders. Now let's maybe talk about the one health system in our province.

Does that affect you right now? Have you seen any changes since they brought it in a few months ago?

[Chief Cadmus Delorme]

Thank you. It's like a new relationship. It's still in the lust area. We don't really know how to go about it yet. The new one health system is only, I believe, four months old, somewhere around there. We have met with the health authority. We met with the Ministry of Health. When I go to those meetings as a chief, I feel like them too. They're still feeling out their new role with one another in regard to the political aspirations and the public [Technical difficulty—Editor]. I think it's a move that has economies of scale.

On the new board, there is, I know, a minimum of one indigenous person. I think they could have addressed that a little better because you don't really know the indigenous issues unless you're an indigenous person. I'm optimistic about it. When I go to those meetings, what we say from Cowessess is that we have one thing in common: we share this land together. We disagree on jurisdictions. Let's leave that conversation to when we need to talk about it. Let's just talk about getting some services between Cowessess and the Province of Saskatchewan.

I feel that we're at the point where I have to ask the province, “Are you in or are you out?” I feel like we spin our tires at those meetings because they keep saying, “Well, we have to hand it off to this person. We have to hand it off to that person.” We bring the papers, we bring the idea, but no one wants to stamp it.

[Kevin Waugh, Conservative, Saskatoon—Grasswood, SK]

I'll hand it over to Arnold Viersen now.

Thanks very much.

[Arnold Viersen, Conservative, Peace River—Westlock, AB]

Thank you, Lindsay, for being here today. I really appreciate it.

I come from northern Alberta. Your organization would deal with a lot of first nation spillover into your communities. Have there been any talks about bringing Heart River Housing facilities to reserves?

[Lindsay Pratt]

No, we have not at this time, but the province is coming out with an indigenous housing program, and I know that there's some CMHC funding available. The town of High Prairie is planning on starting some discussions with the first nations in the surrounding area just to kind of open up the dialogue, because the other thing that we don't understand is what is happening to their seniors now. Up until now, we've kind of just stayed in our little silo and done what we've done, and if people come to us, we serve them, no matter where they come from, but I think it's time for us to reach out to those reserves and settlements and ask, “Where are your seniors going now? What plans do you have for them, and how can we help facilitate that?”

If their facilities are built in our communities, how can we make them culturally acceptable so that they feel comfortable moving in and out? I know the surrounding communities of the first nations and the settlements are very small, so again, you get into the economies of scale and how they can work that out, and it's very difficult for them. Any help that we can be.... Our doors are open. Our board is very proactive in that, and I know the town of High Prairie is starting to look at that. Those are opportunities to move forward.

[Arnold Viersen, Conservative, Peace River—Westlock, AB]

I know that several of the first nations in the surrounding areas have reached out to me to build their own facilities. Would Heart River Housing be interested in participating by bringing some expertise and building those facilities?

[Lindsay Pratt]

Absolutely. Anything we can do.... Again, we can help them where they are now or they can come to us.

Our biggest problem right now is, again, provincial health. They just built a new hospital in High Prairie with 64 long-term care beds, and they're already full. What happens is that level 3 care, where those individuals might come off the reserve and should be assisted in that community, in that hospital, and in that long-term care facility, but are getting pushed back to the lodge or pushed home where the families don't have the facilities to take care of them properly. Again, you run into those situations where the families are trying to do the best they can without the proper resources. If they are going to be pushed back home, then let's support those families doing it on reserve or on settlement. If not, let's give them an opportunity and a place to go.

[Arnold Viersen, Conservative, Peace River—Westlock, AB]

Thank you.

[The Chair, Liberal, MaryAnn Mihychuk]

That ends our time for you, Arnold. I'm sorry. It seemed short. You'll have to talk to your partner.

MP Rachel Blaney.

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

Thank you, Chair.

Thank you all so much for being here today. I really appreciate what you're sharing with us.

I will start with the Deputy Grand Chief, James, or John, whoever would like to speak.

One of the things that we've heard repeatedly through this process is a list. One of the challenges is a lack of adequate data. There are challenges in the realities of multi-jurisdictional frameworks and the lack of funds to build the infrastructure for long-term care homes. There are the challenges of rural and remote communities, which I know that you know a lot about, and the core need for connection back to the community. The last thing is training and human resources.

When you share your stories about those challenges and the theme that you share with us, which is, “I want to go home”, could you tell us a little bit more about what it means to be in your community? How remote are you? How long does it take to get to the nearest care facility, and what are some of the challenges your people face in making that work?

[Deputy Grand Chief Derek Fox]

I can answer that.

As I mentioned earlier, we have 32 remote communities and 49 altogether. You asked us about what conditions are like. As Mike alluded to earlier when we talked about the social determinants of health, I would say that 90% of those would make up our issues. You're talking about education, infrastructure, and social challenges. All these things combined lead to health issues, whether they're for youth, elders, our people, and so on.

I've always believed that we should be investing in those things, including infrastructure, programming for our youth, recreation, hockey, spending time on the land, and being proud of who they are as first nations people—whatever we have to do to ensure they're healthy and that they're raised right.

People in our 32 remote communities all need to fly out to Sioux Lookout or Timmins. A return flight would cost about $1,000 to $1,500. They have to go through the non-insured....They have to pick up the phone and call non-insured, which has to approve them. Sometimes they say no. Sometimes they say yes.

They come into Thunder Bay and Sioux Lookout and have to spend time there. Some of them can't speak the language. They get lost in the city. They get lost in the town. It's a whole process to be leaving their first nation to go to a town in which they're not comfortable and having to survive just to get health care. That's the reality of seeking health care for our people.

As I said, you raised some very good points about the social determinants of health. If we could address those social determinants, we'd all be better off. When the health care issues arise, you find that the federal government or the provincial government, whoever it may be, is bailing out first nations or assisting the first nations with health. If we just invest in the foundation of a first nation, we can try to prevent those crises we see. That's it in a nutshell.

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

One of the things you also talked about is caregiver burnout, how exhausting it can be for families and how little support there is. I've heard that there is home care during the week from nine to five, but not during the weekend. Is that just underfunding from the government? Can you tell me a bit about what that breakdown is?

[John Cutfeet]

Thank you for that question.

The funding for home care is very limited. In our own community, for whatever is funded there, the number of clients they have has grown, yet the funding hasn't. That's one of the issues.

We said that there is caregiver burnout or that a caregiver's health is failing. I was one of those. While I was chief, I was also looking after my mother. The routine, I used to say to keep my siblings informed, was Mom's been watered, fed, drugged, and the door locked. It was the reverse of that in the evening. To do that day in and day out, seven days a week...yes.

When I took my mother home in February 2017, she lasted until August, when she had an accident in her apartment and was no longer able to be by herself. She was removed. There was nobody there to offset my need. Nobody volunteered or even said, “We'll pay you.”

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

For your community—or communities, really—is there one place where you're thinking of having a care facility that everybody would access? Do you have a particular model in mind for long-term care?

[John Cutfeet]

My son is a physician in B.C. The population of the community is about 1,800. They have a small hospital. They have 10 eldercare beds. One of the thoughts we have is, why not have hub models, where at least the elders can be in a native setting, in a native community, where they can use their language and have some company? A hub model is one of the aspects we're looking at.

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

Thank you.

[Deputy Grand Chief Derek Fox]

To give you an example of the hub model he was talking about, we have 32 remotes. We have larger communities and we have smaller communities. What if Webequie, for instance, had the main centre and we had other elders from other areas going to Webequie? It might not be “home” home, but they're in the north: they're home.

That's what he means by hub models.