Indigenous and Northern Affairs Committee on Oct. 3rd, 2018

[The Chair, Liberal, MaryAnn Mihychuk]

Questioning now moves to MP Rachel Blaney.

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

Hello, and thank you all for being here with us today.

Throughout this whole study, we've heard many times that indigenous communities are often far behind the rest of Canada due to a lack of long-term funding. We hear that jurisdiction is a huge barrier because it's part of this going back and forth. I heard a couple of mentions today of issues like if you don't have a status card on reserve and you're there, you can't be eligible for those services, and trying to figure out how you're going to support the community to the best of your ability.

I'll be happy to start with Ms. Traverse first. I'm just wondering if you could just talk a little bit about what that means, to be behind. You talked earlier about palliative care and how you're trying your best to provide it, even though you don't have the actual resources to do it. If you could talk about some of those challenges, I would appreciate it.

[Gwen Traverse]

I have a really strong vision of Pinaymootang being a hub centre, providing primary health care, long-term care within our community based on the 2011 flood impacts. We're slowly seeing communities repatriate homes, but once these communities repatriate homes, everyone's at different levels of health service.

Pinaymootang wasn't one of the communities affected as drastically as the surrounding communities nearby that are 10 to 15 minutes away. Throughout the seven years, we've seen changes happening in our health care that weren't improving. They were changing drastically. We had physicians turn over every two to three years, so there was no sustainability or continuity of care, especially to our diabetes clients.

We took every initiative to ensure that we were bringing services to our community. That's why I made mention that we partnered with a private health firm. If we don't do it, who's going to do it for us?

We partnered with a private health firm from Winnipeg that travels two and a half to three hours to our community just to provide service. We also partnered up with the regional health authority, but it's so limited. Their contract physicians don't care to even provide that continuity of care, so sometimes they'd rather see 10 people while this physician sees 50 and up. It's causing a really high strain on the human resource capacity of our staff.

Based on the impacts we face, we're going to see a high need for mental health, and a high need of care and service for these people who don't have. They're beginning from scratch. The closest place for them to come is our facility, and we can't help but feel an obligation to our own first nation people. If the provincial government is not going to do it, who's going to do it? The liability falls on the first nation.

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

Thank you.

I'm going to go over to Piikani. Going back to that part about the jurisdictionality being a barrier and how you interact, one of the things we're seeing clearly is that it's different in each province. If we're going to look at it as a national issue, how do we look at that but also understand the nuance? If you could talk about that, I'd really appreciate it.

[Keith Grier]

It's pretty much a line drawn in the sand. The Alberta government sits on this side, and we're federally funded. There are conversations about their being able to provide in-kind services, but we're strapped for funding. Our population is growing fast like every other first nation. We have the same challenges as everybody else.

The funding agreement, pretty much 70% of it, is allocated to the employment of those folks inside the existing Aakom Kiyii Health Services department, and then there's so much for programming. The programming is where it falls short, because there's a large demand on the services.

We've tried to address that issue with Alberta Health. At this point in time, it's challenging to say the least, but yes, there's a very clear distinction in Alberta. There's a very clear line that has been drawn.

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

I would like to put the same question to the Okanagan Indian Band. Just where does the rubber meet the road, and what are those challenges to really get the services you need for your community? How challenging is that jurisdictionality?

[Allan Louis]

As you know, I mentioned earlier that we're under the First Nations Health Authority here in British Columbia. Each region—there are five regions—deals with different health authorities. In our region it's the Interior Health Authority. We've made some headway with sharing information. If a patient goes to the hospital, our staff are informed, but sometimes it takes a little bit too long. It might be a couple days behind when the patient is actually in the hospital, and we're not aware of it. The Interior Health Authority in our area takes care of first nation members who live off reserve and also takes care of our needs when we have to go to a hospital or long-term care or palliative care. We have huge issues just as everybody else does.

Currently, with the First Nations Health Authority [Technical difficulty—Editor] agreement that we [Technical difficulty-Editor] twice a year and work through some of these issues that are pretty blatantly obvious and try to break down those barriers. I think that's one thing we've done well. Change can't come fast enough. We're worried about the people who are on the ground needing—

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

Sorry to interrupt but I have only a second.

In the five years that you've had that health authority, have you noticed a difference for your community, in discussing that jurisdictionally?

[Allan Louis]

Yes. In terms of the relationship, it's small but we are moving in the right direction.

[The Chair, Liberal, MaryAnn Mihychuk]

Thank you.

We now move to MP Will Amos.

[William Amos, Liberal, Pontiac, QC]

Thank you, Chair.

Thank you particularly to our witnesses today. This is important testimony. I think many of us here in the room are on a steep learning curve because these are experiences that we have not lived through ourselves. The field of health is one in which, obviously, the province is traditionally predominant, so it's not an area in which I feel particularly comfortable or in any way an expert. I'm a layperson.

I'm interested in knowing about the federal programming with which your communities are engaged directly. What aspects of the services provided do you think are being done well and you support and would encourage more of? What are the aspects for which you think the way the federal civil service is structured or what is being done could be improved? I want to give you an opportunity, because we're going to hear from them as well. I'm sure they will admit they'd love to have more funding to do more things, including capital investments. I think this is a great opportunity also to learn about that.

I'd like to give each of our witness groups an opportunity to speak to that.

Maybe I'll start with Ms. Traverse.

[Gwen Traverse]

In terms of what's working federally, the Jordan's principle fund aimed at children with disabilities has worked very well. It has allowed our children to be kept at home rather than having to go off reserve to ensure they get those services. That was one of the best solutions governments had, funding Jordan's principle aimed at children with disabilities.

In terms of what's not working for us, we're being funded as a health centre, but we're providing more primary health care. Health centres provide prevention, education and awareness, but we're working more beyond that scope. We're providing a service that's more of a nursing station than anything else. We're trying our best to improve systems within what we have in our own community and to ensure that services are being offered in our own home communities.

We need to be recognized as a nursing station rather than a health centre. As I mentioned, we've served a total of more than 800 clients in our communities, as well as the surrounding communities. The non-first nation communities have been travelling into our community just to see our physician, because there are so many things happening within the regional health authority, such as for ambulances, emergency room closures, or physician services that are closed. Our community had to do whatever it took to ensure that services are being provided in the community.

Fund us as a nursing station that's providing better primary health care. As well, what I'd like to see is a long-term care facility nearby in our region that will help serve the surrounding communities, one that's more indigenized and could offer more services. Right now, we have five community members in acute care who have been waiting for two years already to get into a personal care home. It has been a struggle.

Again, going back to the flooding, that caused huge impacts in our communities and it still does to this day. That's why I made those comments. There are going to be greater needs and greater demands in services, especially the mental health aspect.

[William Amos, Liberal, Pontiac, QC]

Okay. Thank you, Ms. Traverse.

Chair, how much time do each of our remaining three witnesses have to get their grain of salt into this meeting?

[The Chair, Liberal, MaryAnn Mihychuk]

You have about two minutes.

[William Amos, Liberal, Pontiac, QC]

If you could be brief in your comments, I would appreciate that, because I think getting your perspective on where we can do better would be helpful.

[The Chair, Liberal, MaryAnn Mihychuk]

Specifically who are you going to start with?

Alberta looks very anxious. Go ahead.

[Keith Grier]

You had asked what is working.

Our home care program seems to be working, but we're short in attracting good, qualified nurses and health practitioners. They want to go somewhere else. We need the dollars and the capacity to be able to attract those people. That's the way it seems to be nowadays, because if you look at the amenities they're being offered by the surrounding towns, that to anybody is attractive, rather than having to come to a reserve where there are minimal amenities and minimal housing. They have to travel in. Those types of components are ones we have to think about.

Some of the shortfalls we see are definitely in medical transportation. It seems to be a big one. With the gas support and being held by non-insured benefits, there seems to be a logistics problem there.

You have to remember that there's a responsibility of the federal government under treaty. It has a fiduciary duty to uphold the proper funding for the nations. We're not seeing that.

I'll give you an example. In Alberta's budget last year, I think they budgeted $21 billion to go into health care. That's over half their provincial budget. If you work that out, it's about $5,200 in expenses on a per capita basis across the province. The federal transfer dollars, we all know, are probably about $1,075 per capita, and then we're only getting half of that on the reserve.

Those are the shortfalls that I see.

[The Chair, Liberal, MaryAnn Mihychuk]

You really didn't leave any time for B.C., but I'll leave that between the two provinces. There was no time for B.C.

Questioning now goes to MP Arnold Viersen from Alberta.

We know you're going to give everyone a fair shot.

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

Thank you, Madam Chair, and you know, we have lots of grace for B.C. when we get a pipeline built.

I'd love to hear B.C. out on the same question, for sure.

What seems to be working and where can we make some improvements?

[Allan Louis]

Working for us is the First Nations Health Authority. We have the ability to work with First Nations Health Authority to build partnerships with regional health authorities like Interior Health in our area. We work on common things. A big issue in most regions is racism. We work with cultural programs looking at [Technical difficulty—Editor] that are delivered in hospitals. This wouldn't be possible if we didn't have a good relationship, and it all started with First Nations Health Authority.

We're looking as well at innovative programs that should change how we fund communities. I speak as a First Nations Health Council representative. I also sit on the health council of British Columbia, so I do know what's going on with the health authority.

What's not working is some of the things that are out of our control. When it comes to healthier citizens or members, we have issues with housing, which is out of the control of the social development department. Education funding is not part of what we control, but it has a big input in how our citizens live and have the ability to make a living.

We all know that the more.... You don't have to be rich, but at least close to middle class, in order to eat better and have that sense of.... I don't want to [Technical difficulty—Editor] because it's not just about money. It brings you the ability to do what you want to do, including what you eat, to partake in cultural events and to raise your children and send them to proper schools. That's is a big one for us.

The other thing that doesn't work is [Technical difficulty—Editor] planning dollars. We live day-to-day when it comes to social development. With a skeleton crew and our numbers increasing every day, it consumes our time and our community. We don't have time to hire or we don't have the funds to hire people to do the planning that we need to carry us into the next five or 10 years.

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

Thank you.

I'll just going back to British Columbia for a moment.

You touched on this a bit, that an ounce of prevention is worth a pound a cure. How is the health authority helping you with working on the front end rather than working on the back end?

[Allan Louis]

I guess the best way to describe it is this. One of the elders at a meeting in British Columbia told us, “We have this river of people who are sick that keeps flowing by us”. We have to start investing in preventing people from getting into that river in the first place. We have to start investing in food safety and how we eat so we don't get diabetes. We have to look at the reasons why our numbers in cancer are rising and why our children are hungry going to school. All that wraps around a healthier citizen.

Another thing is that we're looking for partnerships with education, because we know that people who are better educated live longer and have healthier lives. For example, we discovered that people who have a second or third language tend to have more active minds, and they are usually healthier individuals, so what we're trying to do is to encourage first nations in British Columbia to recapture their language.

That's one of the big pushes that we've done in our immediate community. We have School District 22 onside, and they use the nsyilxcen language as a second language in our community, but we also got the universities to recognize it in British Columbia. They can use the first nations second language or first language, which is their community language, as a alternative to French or....

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

That's good.

Thank you.

[The Chair, Liberal, MaryAnn Mihychuk]

We don't have any more time. Any second now the bells will ring for us to go back to Parliament for another vote.

Before we adjourn, I want to thank everybody for participating in today's hearings. Your testimony will be in the official record and your words will make up part of our report. That's the relevance. We will have the opportunity to give that to all parliamentarians, so what you're recommendations are going to be heard by the ministers, all parliamentarians, and will be in the record for all Canadians.

Meegwetch. Thank you for coming and taking the time on the video conference. It's appreciated.

The meeting is adjourned.