Indigenous and Northern Affairs Committee on Nov. 24th, 2020

[The Chair, Liberal, Bob Bratina]

We have quorum, so it's my pleasure to call this meeting to order.

I'll start by acknowledging that we are on the traditional sacred territory of the Algonquin people in Ottawa, and here where I am sitting in front of the eagles, the Anishinabe, Haudenosaunee and Chonnonton nations.

The committee is meeting to continue its study of support for indigenous communities through a second wave of COVID-19.

Once again, as we start the meeting, there's a selector in the bottom centre of your screen that looks like a globe. When you select it, you select a language in which you wish to communicate, either English or French. When speaking, please speak slowly and clearly.

Once again, our translation is the issue and that is why we need the correct microphone hook-ups and clear speech so that our interpreters can properly interpret. If we don't have the interpretation, we can't properly, by committee protocol, continue the meeting, so keep that in mind.

By the way, keep your microphone on mute until you are speaking.

With us today by video conference for the first hour are the following witnesses: From the west coast we have Jason Alsop, president of the Council of the Haida Nation; Dr. Shannon McDonald, from the First Nations Health Authority, acting chief medical officer; and, Erik Blaney and Dillon Johnson, from the Tla'amin Nation, executive council members.

Welcome to all.

Mr. Alsop, I invite you to begin. You have six minutes to make your opening presentation. Please go ahead.

[Jason Alsop, President, Council of the Haida Nation]

Haawa. Thank you, Mr. Chair. My Haida name is Gaagwiis. I'm Jason Alsop, president of the Haida Nation. Thank you for the invitation to speak to the committee today.

As president of the Haida Nation, I speak from our experience with COVID-19 on Haida Gwaii, and want to share a bit of our experiences and some recommendations in response to the second wave.

First and foremost, what is really important in our response is that when we're responding to the health and well-being of our people and all the people in our territory, there is a recognition of the inherent title and rights in the whole territory that we're responsible for looking after, as well as everybody who lives within it.

One of the most important things identified by the BC Centre for Disease Control on its website is the need for intergovernmental co-operation and coordination. In our experience, we found this to be effective and something that needs greater support in order to support the individuals who have to carry out this work of bringing together all the different jurisdictions.

We have our territorial governance, our band council governance and our municipal neighbours. Many of us share resources and travel between each other's communities. There is provincial jurisdiction, health authority jurisdiction, as well as federal jurisdiction. That underscores the need for co-operation and greater support for those who are bringing people together and reducing the risks by cutting out gaps.

With that, we should include emergency response training for everybody to ensure there's capacity to share the workload and prevent burnout. Many in the small communities wear many hats, and are asked to do a lot. This includes communication efforts. It takes a lot of work and effort to align and share communications for the business community and organizations in order to work together to better respond and better support one another. All of this takes great energy.

There's also the need for personal supports to households and individuals to make sure they can access Internet and connectivity, as some may not be connected. It's an additional cost in order to provide support for accessing Internet and cellular data, as well as the ability to have laptops and computers, which many don't have in our communities.

It's really important to find a way to approach the pandemic on a territorial basis, not just at a community level, and not have our communities feel locked up and put on a reserve. We're able to work federally, provincially, with our indigenous jurisdictions and with our neighbours with whom we share communities and resources.

In terms of opening in a safe way, we need to look after our elders and most vulnerable and provide as much support as we can to ensure they can still be active members of the community. We need to support local and regional measures that indigenous governments, working with others, can implement.

Here on Haida Gwaii, we put in a 14-day isolation requirement for those coming to the archipelago, and that requires great support and coordination. We think it's important to have permits, registration systems and travel declarations that allow people to provide consent for those who wish to enter the territory in a safe way and set the expectations. There's a lot of interest in rapid testing, so we need to work together on having that available if there's a willingness to open in a safe way.

For resiliency in equitable and sustainable recovery plans, it's important to find ways to reduce our dependence on outside sources, and continue to create self-sufficiency for indigenous nations and communities. This includes food security supports for growing food, and continuing to support traditional harvesting, hunting and fishing opportunities, as well as processing, bulk buying and purchasing power to reduce the cost.

In our remote island setting, through our essential work permitting process, we have realized the amount of reliance there is on outside professionals, essential workers, nurses and trades. If we can implement training programs and ways to stop those gaps and that leakage, we can become more self-sufficient. As well, we can invest in housing and infrastructure, clean water, trail networks and other opportunities for people to get outside and be active in a safe way and balance their mental and physical health. We can continue to look forward to our future opportunities to come out of this pandemic and adapt and evolve in this new world and new reality.

I have much more to share, but I think in terms of my first six minutes I'll stop there.

Haawa.

[The Chair, Liberal, Bob Bratina]

Thank you very much for noting the time, and for those remarks.

Next we have Dr. Shannon McDonald.

Dr. McDonald, please go ahead for six minutes.

[Dr. Shannon McDonald, Acting Chief Medical Officer, First Nations Health Authority]

Thank you very much. I'm honoured to be asked to present to you.

I come to you today from Tsawout First Nation, where I live as a guest. I'm originally from Manitoba, am Métis and Anishinabe, and work for the First Nations Health Authority, which means that I work for the nations of B.C.

First nations look at COVID-19 in many ways through the historic lens of previous pandemics and the impacts on the population. Considering the existing health inequities that are inevitable, it seems that the funding we have received is often stated as not being proportionate to the needs, especially in the context of not only the COVID public health emergency but, in B.C. especially, the opioid public health emergency, where we have had significant losses and disproportionate impacts on our population.

At the same time, first nations, recognizing their self-determination and their ability to make decisions about their own people and their own community, have taken part in tripartite relationships, and I want to recognize the support and partnership of our federal and provincial colleagues through this. But as we move through and beyond COVID, we need to ensure that the actions and responses remain rooted in tripartite agreements, governance recognition and the relationships that have been built. We have to find ways to build from health innovation and leadership demonstrated by B.C. first nations and continue that on to battle systemic barriers and reduce those health inequities.

As of yesterday in B.C., there were over 27,000 positive tests for COVID. Among those are 956 first nations individuals, 75% of whom live off reserve.

Our funding is focused primarily on the on-reserve population. That's the way the envelopes are based. Only 44 of those active cases right now are near a community, but over the weekend, we had an additional 58 cases among first nations people. We've suffered 13 deaths thus far, which is not significant when you look at the numbers in the world, but it is certainly significant for the communities and the families who have been impacted.

In the context of the opioid emergency, we're looking at the unintended consequences of some of the public health actions that have gone forward. Lockdowns are dangerous for individuals with opioid substance use disorders, who are being told to stay home and stay alone. Programs and services that could support them in other times are shut down or less accessible during the COVID emergency. It has been extremely challenging to support people who are using alone in their homes.

The FNHA has played an active role in the development of regional plans to implement a partnership with the province. The rural, remote and indigenous community COVID-19 collaborative response framework—it doesn't fit in an invitation—is a collaboration with regional health authorities, provincial officials and health agencies.

In addition to that work and the collective response, we have also developed lines of communication about those reciprocal accountabilities, where we constantly need to be speaking to communities. We hold regular webinars with health directors, with leadership and with community members. There never seems to be enough communication. That's probably one of our biggest challenges. Mr. Alsop spoke to the issues of connectivity. For some of our communities, participating in those communications is increasingly challenging.

We recognized, for example, that there were challenges in accessing primary care during the COVID emergency, as doctors who would normally travel to communities stopped doing that.

We have set up a virtual doctor of the day program allowing for telehealth to provide those services to communities. We've also included a virtual substance use in psychiatry service as part of that, and it's been very important.

Knowing my time limitation, I can't help but recognize the work that's being done right now in the context of the racism investigation that is front and centre in B.C. working very hard to overcome those issues in health care service delivery. There is a report, of course. Mary Ellen Turpel-Lafond's report is expected any time, and there will be a significant resource challenge to respond to that.

One of the things we're really concerned about right now is burnout, burnout of our front-line workers, burnout of our leadership and burnout of our FNHA staff. I think we need to look at that in context and understand. For example, in a meeting yesterday, an elder said to me, “I don't want to take the prioritized immunization.” I was saying we're going to prioritize first nations among the immunization programs, and he said, “No, they're just going to make us guinea pigs. We're not priorities. They're going to use this new vaccine on first nations people to see what happens and then use it on everybody else.”

We really need to understand the context we're working within, the fears that people have and be able to respond to those.

Thank you.

[The Chair, Liberal, Bob Bratina]

Dr. McDonald, we're way over time. Thank you.

Now we'll go to Erik Blaney and Dillon Johnson. Once again, it's for six minutes,

Please go ahead.

[Erik Blaney, Executive Council Member, Tla'amin Nation]

[Witness spoke in Coast Salish as follows:]

Ah jeh Chep Ot. Tiy’ap thote kwuth nun.

[Witness provided the following translation:]

Hello everyone. My name is Tiy’ap thote.

[English]

Thank you, Mr. Chair.

My name is Erik Blaney. I'm an executive council member of the Tla'amin Nation.

I was the fire chief and incident commander for our local community outbreak. Our nation was experiencing an extensive COVID outbreak. At the time, it was the largest outbreak per capita in Canada. After a funeral in the community, we ended up with 36 cases of COVID in a small community of 700 at the end of September 2020.

Our nation sprung into action. We locked down our community, making it one way in and one way out to help protect not only our members, but the members of the neighbouring communities. We initiated a local state of emergency, which forced the closure of all government buildings as well as the only convenience store in the community.

In the midst of the outbreak, we noticed the deep-rooted social issues our nation was facing. We needed some serious help to battle the drug and alcohol and domestic housing issues that were causing our cases to rise dramatically. It was then that we realized we were in a dual pandemic, with the many opioid overdoses happening within the community.

Our hunting and fishing season was significantly impacted this year. Access to cultural activities are causing some major mental wellness issues within the community. Our nation was to host Tribal Journeys this year, which would have seen thousands of people coming to our community. Having to cancel that has had a big impact on the wellness of our community, in that everybody was really excited to have members from both the United States and Canada coming to our community to share culture.

The mental wellness of the first responders and front-line workers needs to be at the forefront of the second wave. Many of us are burnt out and experiencing PTSD from the first wave outbreak. Ongoing access to financial help for those who are off work due to burnout and PTSD is greatly needed.

As an incident commander during the outbreak, funding was the last thing on my mind going into the first few days, but after about four days the bills were stacking up. We worked with EMBC for financial assistance and reassurance that some of our expenses would be reimbursable.

The indigenous community support fund for first wave funding had been expended before we even hit the second wave. About halfway through our outbreak, our second wave funding hit the bank account, which dramatically helped us deal with the issue at hand, in that this funding is non-prescriptive and we could spend it at our discretion.

At the time of our outbreak, checkpoints weren't funded in the community. We were seeing that the checkpoint was actually one of the best ways to control the ins and the outs of the community and to track and monitor who was going into and out of the community, so that we could assist contact tracing with the health officials.

I'm really glad to see that checkpoints are now being funded through, I believe, federal funding that came through FNHA, which then reaches the community. I believe that putting that checkpoint in place the day after we got the positive COVID cases within our community really helped us get our numbers under control. It really helped us stop the spread.

Again, I think six minutes isn't much. I could go on for a couple of hours here, but I will pass the mike over to my colleague Dillon Johnson for more.

[Dillon Johnson, Executive Council Member, Tla'amin Nation]

[Witness spoke in Sliammon]

[English]

Thank you, Erik.

Good morning and thank you, honourable members of Parliament.

I can't say enough about Erik's leadership during the crisis in our community. This man worked day and night for three weeks plus, and we owe him a debt of gratitude as a community for sure.

We did learn a lot of things from the outbreak in our community, some good things, some bad things. The community pulled together. It was really cool to see, but obviously it did expose some real issues.

One thing I wanted to raise with the committee this morning is how the overcrowding in housing in our community worsened the outbreak. We had multiple families living under one roof who were unable to quarantine and self-isolate in a safe way, and this put other loved ones at risk. It also exacerbated the outbreak.

While the worst part of that outbreak is behind us, we continue to be vulnerable, and we need investments in housing. This is why, in collaboration with our fellow self-governing indigenous governments, or SGIGs, we have submitted a housing stimulus proposal to the Government of Canada. The purpose of this is obviously to provide affordable housing to protect our vulnerable people from coronavirus spread caused by overcrowding. It's to address the long-standing housing gap in our communities that continues to contribute to poor socio-economic outcomes. Of course, importantly, it stimulates the economy in our communities and our regions through housing investments. It's providing meaningful employment and opportunities for people to put food on the table and to get through these difficult times.

I believe some members of the committee will have heard of this proposal submitted by the self-governing indigenous governments, and appreciate any support that can be lent towards that. We think housing is not a problem in our communities; it is a solution. We graciously ask for your support for this ask, which is $426 million in a targeted investment for safe and affordable housing in our communities. We have the data to back up this request.

I know I'm running overtime here, but I welcome any questions on that piece. I appreciate the time.

[The Chair, Liberal, Bob Bratina]

Once again to all our guests, if there's any point you want to make sure the committee hears and it doesn't come up in the subsequent round of questioning, please submit written testimony and we will be happy to incorporate it into our report.

With that, we will go to the round of questioning. The first round is six minutes.

I apologize to my Conservative friends. I don't have the list in front of me. Who will be the first speaker for the Conservatives?

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Thank you. It's me.

[The Chair, Liberal, Bob Bratina]

Thanks, Cathy.

Please go ahead.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

First of all, I want to thank all the witnesses who are either on the front line or very close to the front line in what is a very challenging time. I think the medical health officer for British Columbia described it yesterday as not a marathon but a triathlon with certainly no end in terms of that third leg. I can only imagine how challenging it is, and thank you for all that you do.

Dr. McDonald, in the spring you talked about testing. For the communities you're supporting throughout British Columbia, is testing available with the GeneXpert cartridges that are working with reasonably rapid turnaround?

[Dr. Shannon McDonald]

Thank you for the question.

Things have changed. In our work with our provincial partners, we have a goal of 24-hour turnaround for any testing that occurs within the provincial context, regional health authorities especially.

All of our nurses have been trained to gather samples. We have offered that training to independent first nations as well, so that the swabbing can occur at the community level and then be transported to provincial labs.

Our first GeneXpert machine is up and running in Tofino. Yesterday, we received our first positive result in that machine. We have two other machines that should be up and running by the end of November.

There were a few, let's just say, administrative issues to get by with regard to rules and regulations around provincial labs and accreditation and the utilization of these machines in non-hospital environments. We have worked through a lot of that. We have four more machines coming through our federal partnership, and we are in the process of working with communities to select the communities with the most need. Those are the GeneXpert machines.

We are also looking forward to the Abbott ID machines coming, which will allow much more point-of-care style testing that we had originally anticipated would occur with the GeneXpert. It was certainly a lot more complex than we had originally anticipated. We look forward to whatever hand-held point-of-care machines come forward and are prepared to continue to work with our provincial lab partners to enable their utilization.

Every single community I talk to asks me the question about when they will get theirs, and at this point I'm not able to respond to that positively.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Although it sounds like things have improved, I think we're into the second wave and clearly we're not where we need to be yet. Of course, that home point-of-care test, even if it's not perfect, to me, always seemed like a tool that could help guide the decision-making.

My next question is on long-term care. I can't recall whether there are any on-reserve long-term care facilities. If there are, how are things going in British Columbia with first nations-run long-term care?

[Dr. Shannon McDonald]

The First Nations Health Authority does not have any long-term care facilities that we manage directly, but there are some of our communities that have elders lodges or other facilities. So far, we have been very lucky, in that we haven't identified any cases in any of those facilities, but there's certainly a high degree of caution and care. We work very hard, for example, to make sure there is a backup supply of personal protective equipment in each community, and a stockpile in each of the five regions, to ensure that people on the front line get what they need to protect individuals. Those individuals, the elders, will certainly be prioritized in terms of our planning for immunization.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

I remember when the First Nations Health Authority first came into existence, and it was certainly, from my perspective, a really positive step forward.

As you look at managing the pandemic, and having your role and others, what would you say are the pros and cons of the model? I was always surprised that there was not some sort of move in other provinces to create a similar structure.

Would you say overall, for pandemic management, it's sort of net positive? What are the goods and the bads, I guess, of having the structure that's very unique to British Columbia?

[Dr. Shannon McDonald]

It's been a lot of work.

I think the thing that's different about what's happened in B.C. is that we are, in many ways, considered the seventh health authority in the province. That allows me to sit at tables with the other chief medical officers of the region and with Dr. Bonnie Henry. It allows me to meet with deputy ministers of health along with our CEO. Because of the agreements, we are accepted in a different way, as a collective voice.

It's not perfect. We have communities that do not believe they're getting what they thought they were going to get from the First Nations Health Authority. We continue to evolve. As I mentioned, one of our biggest challenges is the off-reserve population and the fact that our funding is based on the on-reserve population. Both in the context of the opioid crisis and the COVID emergency, for example, we are supporting individuals—

[The Chair, Liberal, Bob Bratina]

I'm sorry, but we're running over time, Dr. McDonald. Hold that thought. I'm sure we can complete it.

Cathy, I did find my list, so I'm sorry about that.

Mr. Viersen, you will get your turn.

Right now, it's Ms. Zann for six minutes.

[Lenore Zann, Liberal, Cumberland—Colchester, NS]

Thank you very much.

I'm coming to you today from the unceded territory of the Mi’kmaq in Nova Scotia.

In the spring our committee was told that the pandemic is having impacts on mental health, and you mentioned it as well today. Dr. Stanley Vollant of the Innu Nation COVID-19 Strategic Unit told us, “Our communities were already vulnerable before the crisis; they are even more so now, during the pandemic, and will be even more so after.”

Then on October 27, the Minister of Indigenous Services said to us that the government has invested $82.5 million to address the impacts of COVID, and also said that there was more available if necessary. How is that funding being used? Are people using the online help, the 211 numbers, the 811 numbers, the suicide supports and the mental health online supports? Are people actually using them?

[Dr. Shannon McDonald]

To whom is that directed?

[Lenore Zann, Liberal, Cumberland—Colchester, NS]

To any of you. You can go first, if you'd like to.

[Dr. Shannon McDonald]

I think it's important to hear from the community level, but I will say that the money that has come to the First Nations Health Authority has been utilized in terms of our virtual support, in terms of our ability to provide traditional support to individuals through FNHA, but I think the important piece is the transfer of those funds to the community.

I would absolutely say, and I'm sure my colleagues would say, that it's too little that goes too fast and the ongoing trauma of COVID and the opioid emergency makes it challenging to keep up.

[Lenore Zann, Liberal, Cumberland—Colchester, NS]

Are people actually using the online numbers? They're open 24-7 for anyone who's having problems to call.

Does anybody want to answer that? Community members? Mr. Blaney or Mr. Johnson?

[Dillon Johnson]

I'm not a health expert by any stretch; the funding side of things is more my bailiwick, and I know that we haven't received the funding yet. The reason is it was allocated to ISC, and then ISC was going to allocate it to communities based on their formula of status Indians on reserve. We're a modern treaty nation, self-governing, and it's not an appropriate allocation approach for us.

It really is more revealing of another issue, which is the kind of systemic problem of how to treat our treaty partners between funding decisions made in Canada and how it reaches the community. Currently, that health allocation is tied up with ISC, and we are working with our CIRNAC colleagues to try to come up with a more appropriate allocation. Once we receive that funding, we will be able to provide those supports.

I'm not sure about the extent to which people are using the online support. We do have some local support. We're lucky enough to have a health centre here, and there are some supports available, but I'll defer to Erik to comment more on that.

[Erik Blaney]

Yes, thank you, Dillon.

At the fire hall we have posted all of those supports and we do have a Facebook page on which we have sent out the 211 and 811 numbers. We also have a list of six trauma counsellors in the community who are funded through our local health clinic. Those are made available to us 24-7.

Halfway through our outbreak, I lost five firefighters who just tapped out. They just could not do it any more. They are receiving PTSD help, but there are some major concerns about how they're going to pay their bills going forward. They have to expend their sick days, and once their sick days are out, then they have to apply for EI, I think it is, and then their long-term disability would kick in after about 120 days. It's some more anxiety and tension to put on their plate while they're suffering from PTSD already. I know probably two of them have received the online help, which then funnelled them into some online counselling locally.

[Lenore Zann, Liberal, Cumberland—Colchester, NS]

I'm sorry to hear that. Please give them our committee's condolences and hope that they get better. As somebody who's had mental health issues myself, I know how hard it is, but it is just one day at a time, looking forward.

What measures should be taken to mitigate the long-term consequences the pandemic might have on the mental health and well-being of indigenous people? What should we do to mitigate it in the long term?