Evidence of meeting #118 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 community.
A recording is available from Parliament.
Liberal
Conservative
Kevin Waugh Conservative Saskatoon—Grasswood, SK
Thank you, Chiefs Collins and Peltier, for making the long trip here to Ottawa.
We were told by government officials at Indigenous Services Canada that there are only 53 long-term care facilities in Canada. Ontario has five, so, Chief Peltier, just fill us in. Are you one of the five?
Conservative
Kevin Waugh Conservative Saskatoon—Grasswood, SK
How's that going? There are only five in Ontario and only 53 in Canada. Now you seem to be one of the privileged ones. We could probably quadruple that 53 number, but there are only five in Ontario.
Could you maybe talk about that system of long-term care facilities? There are five in Ontario out of 53, so how do you fit in?
Leader, Wikwemikong Unceded Indian Reserve
We fit into the grand scheme of things, as I believe we've essentially been grandfathered in because our facility was built in 1972. It's one of the earlier ones—actually, one of the first ones—across Canada that was built in a first nation.
The approach at that time, as I indicated earlier, was to have a place for our own community members to go to if they didn't have supports at home. We wanted it to be culturally responsive, where the community members could have their own food and be able to speak their own language with staff members who also spoke the language of our community.
So, from that perspective, it had been operating as it should. Then, in 2007, new regulations came in with the provincial ministry's Long-Term Care Homes Act, which essentially placed our home in non-compliance for a number of reasons. One of the main ones was the diet that we were feeding the community members. Typically, the diet was traditional foods. We had cooks from the community who were adept at preparing the traditional foods, and these foods were the main staple of the daily diet.
Once the regulations came in, we weren't allowed to do that anymore, although, essentially, it was cost-saving in nature because we were able to use the local game and fish. We were able to have that available for the individuals. Now we have to get everything transported in, and it's all processed stuff.
The regulations have really challenged our home because of training requirements and staffing requirements. People with the training qualifications that are required for people in administrative-type positions with regard to the care of the elderly are not readily available close to home or in other first nations. The opportunities aren't necessarily available for our younger generations to come and fill those gaps that exist. Because we've been operating since 1972, many of those individuals are now getting to retirement age, but we aren't able to fill the vacancies.
Conservative
Kevin Waugh Conservative Saskatoon—Grasswood, SK
Yes, we've heard that loud and clear here.
In our long-term care study here, Chief Collins, I think the partnerships are important. You're close to Thunder Bay. Here in government, we're always looking for partnerships. You said that you have 13 communities.
Fort William First Nation
We have 13 first nation communities under the Robinson-Superior legal umbrella.
Conservative
Kevin Waugh Conservative Saskatoon—Grasswood, SK
Could you talk about what your vision is along with, let's say, the City of Thunder Bay?
Fort William First Nation
With regard to the developing numbers in Thunder Bay, you're not only talking about the 13 communities that are in partnership under the legal umbrella. There is also Nishnawbe Aski Nation, and a lot of its members are migrating into Thunder Bay for health care and for health care programming and initiatives. They end up in long-term care facilities, and we continue to work on many aspects on that front to make sure that not only our communities are looked after, but also that their elders are looked after and can feel at home in our community. That's the whole concept around why we're trying to build it in Fort William.
We have a great relationship with the City of Thunder Bay. Our partnership and our structure with the city has strengthened since 2011. We have a declaration of commitment to work together to build our economy, to build our communities and to build northwestern Ontario for that matter. If we stay on track, this opportunity with the long-term care facility that's going to be in our community will provide probably 100-plus sustainable jobs. That will not only impact our community, but also the city of Thunder Bay at the same time.
Conservative
Kevin Waugh Conservative Saskatoon—Grasswood, SK
Yes, that's big.
Since February, we've often heard around this table that data collection is a big problem in this country.
How do we correct that? Should there be one organization, such as AFN, to look after data? It always comes back to the data, and we have not talked enough around this table about a solution to the data aspect.
Fort William First Nation
That's a good point. Maybe it's time for you guys to fund a one-site location for data collection that we monitor, not the federal government or the provincial government or anybody else. It's our data, and it's for our use for making the arguments. We hear the data stuff all the time when we're talking about health care and the opioid crisis and everything. Well, give us our data. We have to go fish around and look for papers that show the impact.
Leader, Wikwemikong Unceded Indian Reserve
One of the proposals that has gone stagnant was the first nations statistical institute that one of the Nishnawbe nation communities, Nipissing First Nation, was looking to establish, but it hasn't been lifted off the ground as of yet.
I know it was a proposal that would definitely take a look at all the data that exists within first nations, as well as all the services they provide. I think it would be an appropriate clearing house, not only for our communities to submit proposals for enhanced programming and services but also through sharing with the Government of Canada as well as the Government of Ontario. They could collaborate more efficiently on the appropriate supports that are necessary.
Conservative
Kevin Waugh Conservative Saskatoon—Grasswood, SK
You mentioned special needs. We haven't even gone there. You talked about autism and fetal alcohol syndrome. Is there any solution to that?
Fort William First Nation
If we had that solution, we wouldn't be sitting here, that's for sure.
Leader, Wikwemikong Unceded Indian Reserve
I can say this: there is programming that exists within the province; however, access to it is very limited, because they will stop at the first nation line. They will not come in. That's what needs to change there.
Fort William First Nation
I want to add maybe a little bit to that.
You see the opioid crisis that's having an impact on all of our communities. It doesn't matter what walk of life you come from. You see them fall and become frail. Those are people who are going to end up in the long-term care facilities. Some of them get so bad. I see some of them in our community. One of them had an arm chopped off. They're so frail now that they really belong in a long-term care facility, not out on the streets.
Liberal
The Chair Liberal MaryAnn Mihychuk
With that, we're going to move the questioning to MP Rachel Blaney.
NDP
Rachel Blaney NDP North Island—Powell River, BC
Thank you, both of you, for being here with us today.
I remember my granny went to residential school from ages 4 to 16. When she was in the hospital, we all had a plan about who was going to be with her at all times, because it was so traumatizing to be in that environment. I really appreciate the mindfulness of bringing that up, because this is also an issue of justice, not only about legalities.
I have a couple of questions.
I'm going to come back to the data, because this aspect really concerns me. I think a lot of communities are erased because small communities simply don't have the capacity to gather the data that is always requested of them.
I'm wondering if you have any thoughts on whether this is something we need to do nationally, so that we have a representation of all of Canada and what's happening in indigenous communities and we can pull out different communities. If we did do something at that level, who would actually get that? I realize that you don't want to give that necessarily to the federal Government of Canada.
Fort William First Nation
No. That's like intellectual property that belongs to first nations. All that data collection is something we need to discuss. We were close at one time. It just broke down and went in a different direction.
With regard to who would get the data, it would be our communities. It would be tools for us to talk about health care or long-term care or schooling issues, and all the different issues that we deal with on a constant basis. The data would belong: in our hands and on our property.
That's the way I look at it, anyway. I'm not sure—
Leader, Wikwemikong Unceded Indian Reserve
There are sources. There's the Institute for Clinical Evaluative Services. It has kept records and they are accessible, at least to our first nation. They categorize them that way. We do have records for the time period of 2002 to March 31, 2015, for all services obtained by our people within the North East LHIN and within Ontario.
It has given us a whole wide range of statistics, but we do know from them that we're 1.9 times more likely to have hospitalization in the first year after diagnosis of diabetes. We're 3.3 times more likely to have an emergency department visit in the first year following diagnosis. We're also 1.3 times less likely to have a non-urgent visit in the first year following that diagnosis. The people with diabetes in my community at one time were 1.9 times more likely to develop heart disease or stroke.
These are critical numbers that we have to deal with. The one that really strikes us is that people in my community are 10.8 times more likely to have an amputation. I'm now seeing amputations on individuals younger than I am. I'm not very aged, and they're younger than me, and that's a cause for concern. I grew up with some of these individuals. Why is this happening?
We know about it from the data that exists and from ongoing monitoring. In fact, working with the province, we initiated.... In 2016, we wanted to establish dialysis services in our community because we had 13 individuals who were travelling two hours each way for dialysis. They didn't have much of a quality of life. We were lobbying and advocating for them to have services within the community. We had to have a requisite number to provide those services in our community because they were doing it in other locations. During the time period when we were advocating for that, in a two-and-a-half-year time period, we lost eight of those 13, because they just gave up.
We've made it an issue with the Ontario Renal Network. We started a screening process. We know who has early onset diabetes and who's at risk. We know how many diabetics are in the community because we've made it a point to assess as many individuals in our community as possible. Now we know we're sitting at about 60% of our population that is diabetic. That's where I'm coming from.
In order to alleviate the long-term care services in the future, we need to do something about the diabetes complications, because they're coming.