Evidence of meeting #144 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.
9:40 a.m.
Liberal
The Chair Liberal MaryAnn Mihychuk
Thank you so much. You gave us a very positive picture. Thank you for your time and getting up early. We appreciate it. You've provided insights on a way forward for your community. I think all of our committee members appreciate that. It will be part of the official record.
On that point, we're going to suspend now. Meegwetch for coming out.
We're going to suspend and we'll have our next session. Thank you very much.
9:45 a.m.
Liberal
The Chair Liberal MaryAnn Mihychuk
Good morning, to you in Sioux Lookout. It's good to see you. Welcome. We're on the traditional land of the Algonquin people here in Ottawa. We will hear from you. You have up to 10 minutes to present and then we'll have a few rounds of questions. I suggest they be five minutes each, if we can get them in, because we anticipate that we might see bells coming. We'll keep you informed and maybe we will not be truncated to a shorter time, but there are some indications that we will.
Welcome, and start any time that you're ready.
9:45 a.m.
James Morris Executive Director, Sioux Lookout First Nations Health Authority
Good morning. My name is James Morris. I'm the Executive Director of the Sioux Lookout First Nations Health Authority, based in Sioux Lookout.
Do you want to introduce yourself?
9:45 a.m.
Janet Gordon Chief Operating Officer, Sioux Lookout First Nations Health Authority
I'm Janet Gordon, the Chief Operating Officer for Sioux Lookout First Nations Health Authority. I oversee the health services delivered by our organization to the communities we work with.
9:45 a.m.
Executive Director, Sioux Lookout First Nations Health Authority
The Sioux Lookout First Nations Health Authority is a non-profit organization based in Sioux Lookout.
We provide what I call “non-medical services” to the 32 communities in northwestern Ontario. Of these communities, 28 are remote. They are accessible only by air and by winter roads in winter. They start using winter roads in early January, and they're just finishing with them now, because the weather is getting too warm.
The services we provide are primary care, mental health care, special needs care, public health care and client services. By “client services”, I mean transportation and accommodation services for patients and clients who come to Sioux Lookout for services. Janet will be explaining those services in more detail. We also provide management and administration services for all physician services within the whole region.
One of the things I want to impress upon you is that all of those communities I just spoke about are scattered in an area about the size of France, in northern Ontario. The population is approximately 30,000, divided among all those communities.
Keep in mind that none of those communities have hospitals, pharmacies or children's mental health centres. All they have are nursing stations, clinics that are staffed by outside professionals. Nurses and doctors will come in.
The nurses are there year round, although I think that about 60% of all the nurses who operate in our area are agency nurses who will come in for two weeks at a time and work there. I don't know if Janet has any details on it, but it's a very expensive way of doing business.
One of the things we're going to be talking to you about is training health workers, who will be trained to focus more on the things the people really need—although the people who go in there two weeks at a time, the nurses and the doctors, can still continue to perform their professional services.
We need to find cheaper and more consistent ways of providing health care services to the people who live in the communities.
One of the things that happened in 2006 was that the chiefs from our area approved what we call the Anishinabe health plan, which is a district health plan. If any of you want copies of it, we can make that health plan available to you. That's basically what we have been following since then. It sets out a comprehensive integrated primary health care model and implementation plan. We've been slowly working on implementing that plan.
I'm glad we are here to talk about capacity-building. It is one of our greatest needs. The Canadian education system, if I might call it that, is just not fast enough for us. It's not producing trained personnel from our area who would stay in our area with this work. It's a very slow process. I was just thinking this morning that, if we were to look at the past 50 years of what that system has done to produce health care professionals, we're going to be waiting a long time to produce trained care workers from our area in sufficient numbers to really have a positive effect on the health of our people up north. I'm hoping you can look at those numbers in more detail in the work you're doing now.
I'm going to turn it over now to Janet, to talk to you in more detail about some of the things we have throughout our area.
Meegwetch.
9:50 a.m.
Chief Operating Officer, Sioux Lookout First Nations Health Authority
In the document we submitted, we have identified some of what we have been able to implement, in terms of training for our communities, knowing that with the Anishinabe health plan, communities have identified that a homegrown strategy would support community needs and career laddering. We want to support existing community health workers, or community-based workers, not just in health, but to expand our skills and knowledge and for them to be able to stay and provide a higher level of care. Whether it's health promotion or prevention of illness, we want to match the right provider to the right service, with a good fit for our communities, and also for them to work hand in hand with professional nurses.
We certainly would like to see more nurses, physicians and other allied health workers from our communities. As you know, our communities have struggled with a lot of issues—poverty, poor infrastructure and not enough of an economic base, compounded by a high burden of illness and other crisis situations, such as mental health and addictions. We are in the process of setting up primary health care teams, as we were able to get some resources from the Ontario government. We are still waiting to see whether that funding will continue, and we've been concentrating on recruiting those positions to provide services for our communities.
We are also in the process of developing a regional nursing strategy, which at this time is mostly delivered by the first nations and Inuit health branch. We would like to see it support retention and recruitment and have a more targeted nursing skills training program, more educational opportunities and a comprehensive mentorship program.
Compensation is a huge issue in our area, as it requires people to have a lifestyle that takes them away from their home and families a bit. We need a more comprehensive compensation package that will draw and keep people in our communities. One of the other things we are in the process of doing is encouraging young people to pursue careers in health care, and have developed some videos and posters. We're hoping to launch that by September.
We've been working with Dignitas International on building our community health workers. It's mostly targeted at diabetes. We have trained workers. We look at different models and continue to build on that model. We think the way our communities could deal with their many health issues or burdens is to have our own people trained and staying in the communities, having higher levels of skills and knowledge and being more readily available in the community—not going in and out, which is what we're doing now with a lot of health care providers.
We need ongoing support for things like that. We've been struggling to do this through grants and proposals that have been developed.
10 a.m.
Liberal
The Chair Liberal MaryAnn Mihychuk
Now we're going to move on to questions by members of Parliament.
10 a.m.
Liberal
The Chair Liberal MaryAnn Mihychuk
We have ParlVu on. If it is a bell, it will give us 15 minutes to get back to the House.
We're going to open with MP Yves Robillard. Go ahead, Yves.
10 a.m.
Liberal
Yves Robillard Liberal Marc-Aurèle-Fortin, QC
Thank you, Madam Chair.
We have heard many witnesses tell us that there is high turnover in health and education professionals, in particular in remote communities. Can you tell us about the effect of that turnover on the results of community health and education among the young people.
10 a.m.
Chief Operating Officer, Sioux Lookout First Nations Health Authority
The high turnover rate of professionals in our communities affects the continuity of care. It affects the level of knowledge that people might gain if they would stay longer in the community. At times, we have seen a huge number of vacancies in our communities of nurses and physicians. We try to fill those gaps with locums, because we provide management of physician services in our communities.
10 a.m.
Liberal
Yves Robillard Liberal Marc-Aurèle-Fortin, QC
The Sioux Lookout First Nations Health Authority conducts training programs for its communities, including a First Nations mental health first aid course, harm reduction training, and various webinar presentations.
How does the training you provide contribute to capacity building and talent retention on the reserves?
10 a.m.
Chief Operating Officer, Sioux Lookout First Nations Health Authority
Most of our training is based on the availability of resources we have. Sometimes we use program dollars to try to support communities, and it builds their skills and knowledge. But mental health is a huge burden in a lot of our communities.
There is a high turnover, and it's not just because of the crisis situation that all of our communities are in most of the time. As an example, I think in the last 20 years we have seen over 500 suicides in the communities we serve.
10 a.m.
Liberal
10 a.m.
Liberal
Yves Robillard Liberal Marc-Aurèle-Fortin, QC
Okay.
Still on the subject of the training it provides, how does the Sioux Lookout First Nations Health Authority evaluate the success of these training initiatives at the community level?
10 a.m.
Chief Operating Officer, Sioux Lookout First Nations Health Authority
One of the things that we've been able to do is provide training through the public health money that we have gotten, and we are in the process of doing an evaluation of that program. Part of that will be to evaluate how our training has impacted those workers we support with some of the training we were able to provide through public health.
As for whether it's in data management or in communicable disease surveillance type of training, these are all one-time types of training that we offer with the resources we've been able to secure for those three years.
Our challenges are securing ongoing funding for ongoing programs that need to exist to continue to support workers on an ongoing basis.
10:05 a.m.
Liberal
The Chair Liberal MaryAnn Mihychuk
All right, you've run out of time, Yves.
We're moving on to MP Cathy McLeod.
10:05 a.m.
Conservative
Cathy McLeod Conservative Kamloops—Thompson—Cariboo, BC
Thank you for your presentation and the very tough job you do in taking care of so many communities with the difficulties you face in getting trained personnel into the area.
I have a number of questions. First of all, I'd like to ask a quick one.
When the government legalized marijuana, it committed to giving 75% of the excise tax to the provinces, and it seemed to forget about indigenous communities across the country. That money was meant to support education and to deal with what was a significant change in policy direction.
Have you gotten any money from the provinces from their share of the excise tax, or has the federal government indicated that you will be getting any portion of those dollars so that you can do work in your communities around this very significant change in policy?
10:05 a.m.
Executive Director, Sioux Lookout First Nations Health Authority
No, we've heard nothing, and that's a political issue that would have to be dealt with by the chiefs whom we represent. We don't yet know what discussions have occurred between the chiefs and the province, nothing.
10:05 a.m.
Conservative
Cathy McLeod Conservative Kamloops—Thompson—Cariboo, BC
Thank you.
So there have been no funds redirected to you to help you provide education for the 32 communities, the youth in those 32 communities, period.
Has there been any difference in your communities since the legalization occurred, or are you seeing status quo, normal?
10:05 a.m.
Executive Director, Sioux Lookout First Nations Health Authority
It's pretty hard to tell. Nothing has really jumped out at us yet. At the present time the chiefs from our area have maintained the status quo of not allowing alcohol or drugs into the community. That's where it's at so far as I know. I've not been informed if anything has changed.
10:05 a.m.
Conservative
Cathy McLeod Conservative Kamloops—Thompson—Cariboo, BC
Thank you.
Have your communities been impacted by the opioid crisis, or have you managed to escape that very tragic situation?
10:05 a.m.
Executive Director, Sioux Lookout First Nations Health Authority
No. It's had a very devastating effect on all of our communities. Starting in 2009 the chiefs whom we represent told us that they had opioid crises in their communities, and they have been struggling with them ever since then.
Many communities have Suboxone programs and are just keeping people as stable as they can, but it's still a big problem. There is no policy or programs other than that to help these people. They are just struggling. It's having a horrific effect on our communities, especially on the children.
