Indigenous and Northern Affairs Committee on Sept. 26th, 2018

[Sharon Rudderham]

Sure. As I said, we began this process more than 10 years ago because we face the same issues as all first nations. We don't have data. A lot of the data we were collecting for Health Canada or INAC—I'm sorry that I don't know the new names—was related to the accountability of funding and the spending of resources, whereas it didn't necessarily support the documentation of needs within the community, and those could be based on stories.

In my community of Eskasoni, we began a research project specific to Eskasoni and we tried to do data linkage through postal coding and all that kind of stuff to see if we could extract information from current databases and work with universities and stuff like that. That wasn't sufficient, so we continued to work on this project and continued to get funding through the aboriginal health transition fund and different initiatives and whatever project funding we could get to continue this work.

Ultimately, after many years, we've developed a unique identifier that does use the Nova Scotia health card number and the INAC registry to be able to link these together, and it's completely under the control and management of first nations in Nova Scotia.

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

Okay. Thank you so much.

[The Chair, Liberal, MaryAnn Mihychuk]

We've run out of time.

We are now moving to MP Will Amos.

[William Amos, Liberal, Pontiac, QC]

Thanks to all three of our witnesses.

I'll start by reacknowledging the fact that we are on traditional and unceded Algonquin territory.

It's a real privilege to have you here with us, so meegwetch, Ms. Decontie. Thank you also for being an important leader in the health and social services field in KZ. I know you're on the board of the Wanaki Centre, so your responsibilities are actually really broad—a substance abuse centre and the health and social services centre.

As irony would have it, Pauline Whiteduck once worked with my father before I was even born, so there's a little connection there.

I wanted to bring in Mr. Parsons' comment around the need for capital infrastructure and bring that question to you and ask you to put it in a Kitigan Zibi context. If the federal government were to be asked by Kitigan Zibi to enable capital infrastructure investments to enable greater long-term care, is that something that's in the field of dreams, something that is sought?

I have a sense of the complexity of the relationship between CISSSO, the regional health authority in KZ, and it's complicated for everyone without even introducing the federal government into the equation. I almost want to park that issue of jurisdiction and just go to an area where the federal government might have a more direct play, which is to finance needed infrastructure. What does Kitigan Zibi need and want when it comes to long-term care infrastructure?

[Robin Decontie]

We were actually discussing this prior to coming here and saying that we're in the same boat as to the need for greater infrastructure investment in long-term care facilities. Capital is always a challenge to our community, and when we have access to increased operational costs with nowhere to put people or nowhere to practise service delivery, that becomes an issue, of course.

Infrastructure investment would go into long-term care units in our community, for sure. There is no doubt that there can be an extension of what we have, but with that we would need to look at the legal components of care practice, because we could have a facility, but sneaking around to provide care for our people that we may not be regulated to do should not be an issue for us. We need to be able to have some sort of mechanism in place to resolve that with our provincial medicare systems.

The two go hand in hand, I would say. We need the infrastructure investment to create the building for people in long-term care situations, as well as the regulation body for safe and proper medicare that we can provide ourselves with the proper supervision and rights to do so in our own communities.

[William Amos, Liberal, Pontiac, QC]

Thank you.

I understand that there has been a promise made by the previous provincial member of the national assembly, and, I believe, by the current provincial government to invest in a significant seniors' care facility in Maniwaki. It's not clear to me how that works with neighbouring Kitigan Zibi. For those who don't live in that community, they're literally right beside each other.

I'm trying to figure it out because I'm not discussing these matters with the provincial health minister.

[Robin Decontie]

I'm glad you brought that up. I'm not clear about it either.

The provincial medicare system is indicating that this infrastructure will be happening close by. We've offered to be involved. I have two nurses who are willing to go and be part of the development committee. We have not heard from them. I don't know where this project is going, and this is not unusual in working with the province. We'd like to work in partnership. However, it has always been difficult to work with the province as far as accessing medicare and playing in a partnership role. It's very difficult.

[William Amos, Liberal, Pontiac, QC]

Okay.

[Robin Decontie]

This is where we need some work done.

[William Amos, Liberal, Pontiac, QC]

Maybe that's an area for future collaboration. I'm always aware of doing things according to protocol, making sure that I go through chief in council first, but I think the invitation should be an open one from our end, to work with Kitigan Zibi to engage with the province in a discussion around that. It will be a major investment for the region, and it would be a pity if it weren't done in a manner that was collaborative with Kitigan Zibi's health and social services.

Are there other major health care infrastructure objectives that you have presently? We're talking about long-term care in general, but I'd like to open that up to you as well, so that you have the opportunity.

[Robin Decontie]

Expanding our service delivery for those struggling with addictions is something that we need to look at in connection with long-term care. They are biologically harmed as individuals and won't return to the normal state of being they had before their higher level of addiction got the best of them. We're concerned, especially about the young men, the younger male population in the community, who are engaging in a higher level of addiction.

We would like to have that addressed somehow internally. We're looking at it internally, but we need to be able to practise more medicare in that area and to work in partnership with the province and to be on board with the province as well.

We'd like to increase our service delivery at the health centre and increase our nursing authority to practise more of the nurse practitioner type of care that's being offered with proper supervision.

It's mainly the medicare issues we're having with the province that seem to be the obstacle areas we're trying to deal with.

I was hoping to be able to contact the SAA liaison we have to see what kind of connection we can communicate with our provincial facilitator to do that.

[William Amos, Liberal, Pontiac, QC]

Meegwetch.

[The Chair, Liberal, MaryAnn Mihychuk]

Thank you.

We move questioning to MP Viersen.

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

Thank you, Madam Chair, and thank you to our guests for being here today. I really appreciate it.

Robin, you talked a little bit in your remarks about traditional food—wild meats, and that kind of thing. Could you give me a little more detail on that issue?

[Robin Decontie]

I was indicating that if we resort to being certified by the province to have a group home for semi-autonomous people, we would need to comply to their provincial standards of safety, of service delivery and whatnot. We don't necessarily want to do that if it means giving up the types of community traditional foods we want to eat. We like to eat moose meat, and that's considered wild game in a kitchen of a certified semi-autonomous home. That may present bacterial infection and whatnot, according to their infection prevention and control guidelines.

There would need to be some sort of mechanism to enable certification of long-term care homes on reserve to be culturally appropriate, rather than following what the provincial standards are.

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

Earlier you mentioned addiction among your young men. We did a study on suicide prevention in the north. One of the big things they talked about was how hunting and getting out on the land really helps. It seems to me that there would be a nice bridging mechanism to get the wild meat into the seniors care facilities while also giving the young men some sense of meaning again.

Is that a possibility where you are from?

[Robin Decontie]

Yes. That would be a possibility if we were to expand our care facilities. Having the young male population assume the caregiving role for our elderly would help to bridge the gap there.

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

Okay.

Do you have a clear recommendation that you could make around the wild meat or maybe traditional...?

We often like to say, “I'd recommend this.”

[Robin Decontie]

I would recommend to the SAA liaison at the ministry of health and social services to start to network with their boards. There are, I believe, 17 regional boards in Quebec. They need to recognize the importance of networking with us in determining certification standards. We want to be accountable. We want to be certified. We want to have safe and secure care practices in our community. We want that. We are willing to work with the province. However, the communication network and communication linkage is not there.

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

And you just started eating moose meat yesterday, I'm sure.

[Robin Decontie]

Oh, oh!

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

Sharon and Stephen, you mentioned a earlier that you had a per diem kind of agreement with the province.

[Stephen Parsons]

Not yet.

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

Okay.

Are you aware of anything from the federal level from one of the departments? When we had the department officials here right when we started this study, they talked a bit about how they are often not in the business of building facilities but are often in the business of funding the day-to-day care of individuals who happen to be in a facility anywhere in the country.

Have you pursued that avenue? From your perspective, what does interacting with the federal government look like?

[Stephen Parsons]

I'm smirking because you mentioned recommendations. I will have a couple before I leave today, if so warranted.