Evidence of meeting #115 for Indigenous and Northern Affairs in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was services.
A recording is available from Parliament.
4:15 p.m.
Liberal
Gary Anandasangaree Liberal Scarborough—Rouge Park, ON
Yes. Thank you.
To Loon River, I understand you currently have an extensive diabetes program that supports expectant mothers, youth, and the general community. How do you deliver those services currently? What's the delivery model?
Second, how is this programming developed, and how could this model be expanded to support such issues as long-term or palliative care?
4:15 p.m.
Home Care Coordinator, Kee Tas Kee Now Tribal Council, Loon River First Nation
I'm not sure. In the community, we do have programs for diabetes, maternal child health, and Canadian prenatal nutrition. We develop them using members from our communities. We educate them to build their capacity, so it will play into the prevention aspect.
However, in the cse of long-term care, because we don't have any, our long-term care clients end up going off reserve. We have to go through a process with the province. We work as a team, but really we have nothing toward the long-term care of our clients, because once they're in long-term care, they're off reserve.
4:15 p.m.
Liberal
Gary Anandasangaree Liberal Scarborough—Rouge Park, ON
Ms. Dick, can you advise us on whether your organization has developed any programs, such as sensitivity training or any other training modules, that will help nurses provide care to indigenous communities?
4:15 p.m.
President, Association of Registered Nurses of British Columbia
Our association has not directly created those. There are a lot of modules throughout B.C. Most of the health authorities have mandated that nurses take the cultural competency training. A lot of the community reserves I've visited have the same sort of policies created and set in place. They purchase those services through the health authorities. They purchase provincial services because it's such a good program. The problem is that it's mandated through orientation—to have this job, you have to do this—but nobody is overseeing it. I went and talked to 12 nurses, and eight of them hadn't even looked at the program. Nobody is keeping track of it.
There are lot of programs out there. I've seen them across the other provinces and territories too.
4:15 p.m.
Liberal
Gary Anandasangaree Liberal Scarborough—Rouge Park, ON
What would be the appropriate authority to monitor that? Would it be the nurses association? Would it be the registrar? Would it be...?
4:15 p.m.
President, Association of Registered Nurses of British Columbia
I personally have always advocated for the regulatory body, the people who give us our licences. It's part of our licensing requirement, when we sign off as self-regulating, that we be culturally competent, but that's not enforced. In some cases it doesn't occur.
4:15 p.m.
Liberal
Gary Anandasangaree Liberal Scarborough—Rouge Park, ON
Of the programs you have currently, do you know if any of them were co-developed with first nations communities?
4:15 p.m.
President, Association of Registered Nurses of British Columbia
Yes. All of them were. They have done really well.
In terms of programs, I think Loon River talked about how they create their diabetic program from their community needs and get that information from them. I see that more and more as I travel around.
When programs came in and told you “This is what we're doing, and this is how we're doing it for you”, it never worked. People didn't show up for their appointments.
4:20 p.m.
Liberal
Gary Anandasangaree Liberal Scarborough—Rouge Park, ON
One of the things we've heard a number of times in other studies we've undertaken—and we're certainly hearing it again in this study—is the major challenges in recruiting and retaining health care professionals, particularly nurses, who are from indigenous backgrounds. Can you give us a sense of maybe the top three things we need to do to improve that and to support individuals who want to go into nursing?
4:20 p.m.
President, Association of Registered Nurses of British Columbia
For the most part, what I've heard across the province is that wage parity is huge. Band-hired nurses are paid significantly less than a unionized nurse who works within the health authorities, or a provincial nurse—up to 20% less, sometimes 30%.
Also, on job safety, quite often these are fly-in communities and quite often you're the only nurse there. There's no one to bounce things off; you're working within your own specific scope of practice, and quite often nurses working in indigenous communities don't get the proper training for outpost nursing, so to speak. They have their immunization certification and they have whatever under the policies, but they get these emergencies that they have to answer to and can't really say no to, and it just doesn't fit. We're not—
4:20 p.m.
Liberal
4:20 p.m.
Conservative
Arnold Viersen Conservative Peace River—Westlock, AB
Thank you, Madam Chair, and welcome to our guests, particularly those from Loon River. I know that community well.
Most of my questions will be directed the Loon River folks. I participated in the Celebration Days event last summer. One of the things that struck me was the significant respect that the community has for its elders. I saw the place of honour that they were given at the dinner table and how the entire community seemed to rally around them.
I was wondering about the long-term care. You note that there's only one member in long-term care, I assume off reserve. How does the community take care of its elders currently? What does the culture around that look like? I know that off reserve, typically, children most often take care of their elderly parents until they're moved into a seniors facility. How does that look on reserve? Is it the children, or is it an entire community involvement? Is there a particular grandmother that takes care of the old folks? How does all of that work?
Could we get a picture of how it works, particularly in Loon River, but maybe even more broadly in the whole Kee Tas Kee Now region?
4:20 p.m.
Director, Health and Social Services, Loon River First Nation
Thank you, MP Arnold. It's nice to see you.
4:20 p.m.
Conservative
4:20 p.m.
Director, Health and Social Services, Loon River First Nation
It takes a community, just like for children it takes a community. We appreciate our elders very much. They are a priority in our community, along with our children. It was good to see you at our Celebration Days.
I would like to bring up our assisted living program here with regard to your question, because a lot of the family members do take care of their own. I took my mom out of long-term care last summer, in July, and she's home with me. I'm also an LPN. I look after her. At the same time, I'm here at work. I pay someone to keep my mom so I can keep my job.
A lot of the families are looking after their own elders—their mom, their dad, and their kokum and nimosom, their grandma and grandpa—but under the assisted living policy as it reads now, we can't pay for family to look after their own. It's kind of not fair, because the family members can't work. Some of them have to resign from their jobs to look after their elders. It's really not fair with that barrier being there to prevent us from compensating the families. Yes, it is their family, but at the same time, they possibly have to go onto social assistance. Some of them really don't want to go that route, but sometimes they have no choice because the assisted living program is so limited in funding. Also, the eligibility criteria to get help there is limited.
It just doesn't work. It's not working for us right now, so the band has a band-funded program to accommodate that need for the people to look after their own. It's funded by the band. We don't get help from anywhere for that. That's what we have to do to meet the needs of our elders right now.
4:25 p.m.
Conservative
Arnold Viersen Conservative Peace River—Westlock, AB
I know that Loon River is located right next door to Red Earth Creek there, and there are a number of seniors who live in Red Earth Creek who will be looking for elder care in the near future as well. Is there any opportunity to collaborate with the local community?
4:25 p.m.
Director, Health and Social Services, Loon River First Nation
There is that opportunity, and when we did the feasibility study, we did have that in there also, that facility that we're dreaming of right now that we want to become reality. It does include not only KTC member nations but also the hamlet of Red Earth and other surrounding communities north of us. We were open to that, and the feasibility study we had done did show that it would be better to have an open facility versus just KTC member nations.
Yes, we do work with Red Earth, and we also invite them to the services we have, which they can access in the health centre, such as seeing a physician. They come here to see the physician weekly. We do communicate with them and we work with them, even now. We go as far as sharing activities with them, like a Father's Day activity. We invite them and include them in our activities, and they do the same for us.
4:25 p.m.
Liberal
4:25 p.m.
Liberal
Dan Vandal Liberal Saint Boniface—Saint Vital, MB
Thank you.
First of all, I thank the presenters for their presentations. They're very, very good.
My first question will go to Loon River First Nation.
According to your presentation, a health centre was opened in 2000. I want to ask about the financing of the health centre and how it's divided up among the jurisdictions for the different services that you provide. Can somebody give me a basic overview of that?
4:25 p.m.
Director, Health and Social Services, Loon River First Nation
The funding comes from FNIHB, First Nations and Inuit Health Branch, for our health programs. That includes nursing and all of our other programs like home care, public health, and all that.
4:25 p.m.
Director of Health, Kee Tas Kee Now Tribal Council, Loon River First Nation
It's 100% funded and operated by the federal government.
4:25 p.m.
Liberal
Dan Vandal Liberal Saint Boniface—Saint Vital, MB
It's 100%—both the capital and the operating funding?
4:25 p.m.
Director of Health, Kee Tas Kee Now Tribal Council, Loon River First Nation
Yes.
4:25 p.m.
Liberal
Dan Vandal Liberal Saint Boniface—Saint Vital, MB
If you were to make a suggestion for improved federal government services, what would it be?
4:25 p.m.
Director, Health and Social Services, Loon River First Nation
I think that brings us back to the study that you guys are conducting right now with continuing care on reserve, because our ultimate goal is to one day have that facility here. It would be a service to all our....
