SCYR Committee Meeting

37th PARLIAMENT, 1st SESSION

Sub-Committee on Children and Youth at Risk of the Standing Committee on Human Resources Development and the Status of Persons with Disabilities

EVIDENCE

CONTENTS

Wednesday, May 1, 2002

¹

1535

The Chair (Mr. John Godfrey (Don Valley West, Lib.))

¹

1540

Mr. Abu Nazir (Director, Health Funding Arrangements, First Nations and Inuit Health Branch, Department of Health)

¹

1545

¹

1550

The Chair

Ms. Marcia Peters (Community Development Officer, Walpole Island First Nation)

¹

1555

The Chair

Ms. Marcia Peters

The Chair

Ms. Marcia Peters

The Chair

Ms. Marcia Peters

The Chair

Ms. Marcia Peters

º

1600

º

1605

The Chair

Mr. Larry Spencer (Regina--Lumsden--Lake Centre, Canadian Alliance)

Mr. Abu Nazir

Mr. Larry Spencer

Ms. Marcia Peters

Mr. Larry Spencer

Ms. Marcia Peters

º

1610

Mr. Larry Spencer

Ms. Marcia Peters

Mr. Larry Spencer

Ms. Marcia Peters

Mr. Larry Spencer

Ms. Marcia Peters

Mr. Larry Spencer

Ms. Marcia Peters

Mr. Larry Spencer

Ms. Marcia Peters

Mr. Larry Spencer

Ms. Marcia Peters

The Chair

Mr. Abu Nazir

The Chair

Ms. Marcia Peters

The Chair

Mr. Abu Nazir

The Chair

Ms. Monique Guay (Laurentides, BQ)

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1615

Ms. Marcia Peters

Ms. Monique Guay

Ms. Marcia Peters

Ms. Monique Guay

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1620

The Chair

Ms. Monique Guay

Ms. Marcia Peters

The Chair

Ms. Marcia Peters

Ms. Monique Guay

Ms. Marcia Peters

Ms. Guay

The Chair

Mr. Alan Tonks (York South--Weston, Lib.)

Ms. Marcia Peters

Mr. Abu Nazir

Mr. Alan Tonks

The Chair

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1625

Mr. Alan Tonks

The Chair

Mr. Alan Tonks

The Chair

Mr. Alan Tonks

The Chair

Mr. Alan Tonks

Mr. Abu Nazir

Mr. Alan Tonks

Mr. Abu Nazir

Mr. Alan Tonks

Mr. Abu Nazir

Mr. Alan Tonks

Mr. Abu Nazir

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1630

Mr. Alan Tonks

Mr. Abu Nazir

Mr. Alan Tonks

The Chair

Ms. Anita Neville (Winnipeg South Centre, Lib.)

Ms. Marcia Peters

Ms. Anita Neville

Ms. Marcia Peters

The Chair

Ms. Marcia Peters

Ms. Anita Neville

Ms. Marcia Peters

Ms. Anita Neville

Ms. Marcia Peters

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1635

Ms. Anita Neville

Ms. Marcia Peters

Ms. Anita Neville

Ms. Marcia Peters

Ms. Anita Neville

Ms. Marcia Peters

Ms. Anita Neville

º

1640

Ms. Marcia Peters

The Chair

Mr. Abu Nazir

º

1645

The Chair

Mr. Abu Nazir

The Chair

Mr. Abu Nazir

The Chair

º

1650

Ms. Marcia Peters

The Chair

Ms. Marcia Peters

The Chair

Ms. Marcia Peters

The Chair

Ms. Marcia Peters

The Chair

Mr. Abu Nazir

º

1655

The Chair

Mr. Abu Nazir

The Chair

Ms. Marcia Peters

The Chair

»

1700

Ms. Marcia Peters

The Chair

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CANADA

Sub-Committee on Children and Youth at Risk of the Standing Committee on Human Resources Development and the Status of Persons with Disabilities

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NUMBER 024

l

1st SESSION

l

37th PARLIAMENT

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EVIDENCE

Wednesday, May 1, 2002

[Recorded by Electronic Apparatus]

¹  (1535)  

[English]

    The Chair (Mr. John Godfrey (Don Valley West, Lib.)): Now that we've done the scheduling, let me welcome you here. Let me welcome as well, most appropriately, the Forum for Young Canadians, who are here from all across Canada, de tous les coins du Canada. Soyez les bienvenus, mes amis du Forum.

    It is entirely appropriate you should be here. One of the features of the delegation of parliamentarians going to New York next week, to the UN Special Session on Children, is that representatives of youth from across the country are going with us. The fact that you would come to our committee meeting is absolutely in the spirit of what we're up to.

    We recognize you are not children; you are youth. We hope you're not at too much risk, but if you are, this might be useful. I don't know.

    Let me tell you very briefly what we're doing here, just so you have a bit of a sense of it. This subcommittee represents all the parties. The Liberals are on this side. We have a member of the Alliance Party and une membre du Bloc Québécois qui est là, Mme Guay.

    What brings us together is a common interest in the problems that face children and youth, particularly those we view to be at risk. Our current work focuses on aboriginal kids, and specifically aboriginal kids from conception to the age of six on reserve. Later on we will be doing work on off-reserve kids from six to 12, but right now we're focusing on that group.

    Throughout the fall we've had a number of witnesses who have come from the Government of Canada to tell us about the programs we have for those children from zero to six on reserve. Then we've been hearing from people themselves who live on reserve, who work on reserve.

    Today's guests—and I hope I'm going to get this right—are from the Department of Health and from the Walpole Island First Nation. The question we were discussing last time, and why we're interested in hearing from our two witnesses to help us understand, is how does it actually work when the federal Department of Health makes special arrangements with first nations across the country so that they may run health programs through health centres. How does that work?

    Is this what you understand your mandate to be, dear witnesses?

    Voices: Yes.

    The Chair: Oh, this is reassuring. It's always good when we're all in line here.

    It's also excellent that Marcia Peters is here. We're very pleased you're here from the Walpole Island First Nation to tell us what it's like at the other end, the receiving end. And it's good that that's what you think we're here for. It's always wonderful when everybody's on the same page.

    So let me welcome the two guests, and I propose we begin by hearing from you in the order in which your names appear.

    Mr. Nazir, welcome, and please begin.

¹  (1540)  

    Mr. Abu Nazir (Director, Health Funding Arrangements, First Nations and Inuit Health Branch, Department of Health): Thank you, Mr. Chairman.

    I'm here today to provide some information to you on how Health Canada provides a mechanism for first nations to manage their own health programs that are normally delivered by Health Canada, primarily through the first nations and Inuit health branch.

    About 14 years ago the department received authorities from Treasury Board to provide a mechanism to support first nations, at least those who wished to manage their own health programs. The mechanism was a type of contribution arrangement with specific terms and conditions.

    Along with that was a framework under which the first nations will deliver the program and Health Canada will ensure that the programs or services are delivered appropriately.

    With that framework there were some principles. The important ones were that in this framework there should be some form of community development—both socio-economic and cultural—and that there should be some linkages with the general health care system. An important one was that the pace of transfer is to be at the discretion of the first nations community, based on their own community readiness.

    This is a result of many years of prior studies, including the introduction of the Indian health policy of 1979. The objective of the transfer program is basically to enable first nations and Inuit communities—because it was not only for first nations but also Inuit—to design health programs and allocate resources according to their own health priorities.

    The second was to ensure that communities have some flexibility in how they actually deliver the programs and services.

    The third was to strengthen the accountability between the chiefs and councils and their own community members in terms of the services they deliver to them.

    The last was to ensure there was some form of public health and safety, in terms of basic or mandatory health programs that should be maintained.

    But the underlying factor was to build capacity within the first nations communities. For that, they needed some level of administrative, financial, and governance capacity. We had to ensure they had a minimum level of human or institutional capacities. The funding provided for it should afford them to do that.

    There are many other mechanisms than what we refer to as a transfer agreement. The transfer agreement is technically another form of contribution agreement. We have other forms of contribution agreements with first nations that we deal with across the country, but the transfer agreement is unique in the sense that it provides a different level of governance and a different level of flexibility, and it is not unique because Indian and Northern Affairs have a similar authority.

    Where are we with transfer? Since its introduction in 1988 we have about 276 first nations communities who are managing a transfer agreement. This is about 47% of the communities who are eligible to enter into this type of health care delivery. The remainder are in other forms of contribution agreement. In terms of resources, there is about $180 million of programming in these agreements for these 276 communities, and it affects over 190,000 first nations individuals in these communities across the country.

¹  (1545)  

    In terms of the transfer of framework, it's divided into four parts: There is a pre-transfer planning phase; there is bridging to ensure that they are ready to do this; there is the implementation phase, where we have to work with them to ensure that the deliverables are there; and then there is post-implementation, where we work with them in terms of their accountabilities.

    There are four major accountabilities: they must have a community health plan that will delineate their health priorities and their structure and the resources they have; an annual audit; an annual report to their members and to Health Canada; and every five years there should be an evaluation of the community agreement we have with them.

    In terms of the benefits of that, it varies by first nation. Through national evaluations we've done in the past and through the community evaluations we've been receiving every five years from each of these communities, they themselves have reported that they feel they're better off than the way it was delivered before, because they have more awareness of their own health issues; they're able to deal with their own priorities; they're able to develop their own management skills and to recruit first nations to run these programs themselves where first nations with appropriate skills are available; some are able to integrate some of their programs and services; and most importantly, they feel that they're able to integrate their spiritual and cultural aspects for their communities.

    That does not mean everything is perfect. There are challenges, because we're dealing with health care, and in the general health care system we have challenges similar to those we have with first nations that are managing their own programs.

    They have the issue of program integration. They would like to integrate not only programs and funding that they get from the federal government, but they would like to do it with provincial governments, NGOs, and any other source of funding they might be receiving.

    They have the issue of population growth. Their population is increasing, and they feel that the federal government should continue to provide appropriate resources to meet those demands. Also, regarding normal cost of living increases, they would like to see the federal government continue to provide appropriate growth in those areas.

    In the area of capacity, they also have challenges in terms of whether they are able to do that within their own communities. It varies across the country in terms of the size of the community. Some of them are forced to form collectives with other communities so that they have the economies of scale.

    They have the issue of recruitment and retention of health care workers, just like we have in the general health care system, the issue of accountability, and issues around timeliness of reporting and their capacity to sustain that over the long term due to turnover of staff.

    And then there's the challenge of data collection and outcome reporting that we all face in the health care system. They have the same challenges, and they feel it's more acute because they have smaller resources and less access to databases and other health information from other jurisdictions.

    So that's a short summary of issues around transfer agreements.

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    The Chair: Thank you very much. That was admirably condensed, and we thank you for it.

    Now we go from, as it were, the Ottawa end to the on-the-ground end, and we're delighted to welcome Marcia Peters--a person we've heard a great deal about, and here she actually is. It's wonderful. We're so delighted you're here, and we'd like to hear you tell us about Walpole Island. Tell us where it is, how it works, and what we ought to do.

    Ms. Marcia Peters (Community Development Officer, Walpole Island First Nation): Thank you.

    [Witness speaks in her native language]

    Hello. My name is Marcia Peters. I'm from Walpole Island First Nation.

    I'd like to start back from my roots and where I come from. I am the descendent from a residential school survivor. My father attended Shingwauk Residential School in Sault Ste. Marie. I'm one of nine children. I'm the youngest in a family of nine children. He attended residential school from the age of 10 to 16 years old. In all those years, he never got to come home. That's a pretty good sketch of what a lot of people from Walpole Island experienced.

    I'm married and I have a four-year-old son. He has Down's syndrome. I come from a proud nation of Anishnabek from Walpole Island First Nation. We are very proud of the fact of being the first aboriginal community in Canada to get rid of the Indian agent in 1965. We also boast of having the first day care on a reserve in Canada. I am an advocate for first nations children, especially those with special needs, and residential school survivors and descendents. Right now, I'm employed at the Enodmaagejig Social Services. My job title is community development officer.

    The Walpole Island First Nation are Bkejwanong. Their ceded territories are home to the people of the Three Fires Confederacy—the Ojibway, Ottawa, and Potawatomi people. The total population as of the year 2000 was 3,642, with approximately 364 children from birth to six years old.

    The federal programs available to the children on Walpole Island include Brighter Futures, Building Healthy Communities, the Canada prenatal nutrition program, the national child benefit, the federal child care initiative, education, health, band representative, and the child witness to violence program within our women's shelter.

    There had been discussions about restructuring of social service programs introduced in Walpole Island First Nation in the early seventies. An attempt to implement this new structure in 1993 had been unsuccessful. However, the fundamental need and desire to improve services for community members, along with a very real and growing concern about federal and provincial program funding cutbacks, have had the effect of generating both renewed and additional support for program coordination.

    In 1995, the Partnership Task Force was created, consisting of social service program coordinators and community members. In October 1997, a study called Social Services Development Project was commissioned by the Partnership Task Force. The purpose of the study was to evaluate existing services and to formulate recommendations that, if accepted and implemented appropriately and effectively, would help to move the social service programs in a desired direction. I'm proud to say the Enodmaagejig Social Services has just recently completed its first fiscal year of operation under the newly restructured model.

    The current system and health of our children--and this is a pretty point-blank statement, I guess, for my first one here: the current system is inadequate on reserve. In some instances, it is working only because we are forced to work with what we have.

    Below are 10 points to consider as evidence. One, our funding caps are a concern that ultimately affect our children. It's an overall concern for our first nation because of unmet needs. The population continues to grow, but the resources are not adjusted accordingly. Restrictions on funding make it difficult to meet the needs of the community.

    Abu mentioned something that caught my ear when he noted the cost of living. There are no increases in that area, so I guess maybe that falls into the same category.

¹  (1555)  

    Am I talking too fast? They asked me to talk slowly, so I'm trying.

    The Chair: The real issue is whether the interpreters are... Is it okay? Not too bad?

    A voice: Yes.

    The Chair: Fine. Carry on.

    Ms. Marcia Peters: Okay. I'll try.

    Our second issue is financial flow of resources through established provincial funding silos—i.e. the money is not directly flowed to first nations. It's a major concern. There is a perception that we lack the infrastructure to administer the funding flow of resources, and funds are diverted to agencies in neighbouring communities that are contracted to service our community. This limits access to these services off reserve because of transportation issues. When these services are offered within the community, they are culturally inappropriate and culturally insensitive, making the overall service inadequate for our families and babies.

    Our third point is that the basic need of shelter remains an issue for our babies. Inadequate housing within the community has caused 10% of our total population, which we consider on-reserve population, to reside in neighbouring communities such as Wallaceburg and Port Lambton. This issue has caused our children to grow up in a strange environment where they are unable to maintain their identity as aboriginal people.

    The Chair: Could I just interrupt? It's simply a geographic question. Can you tell us exactly where Walpole Island and Wallaceburg are, for those who aren't from Ontario--and indeed, for those who are from Ontario?

    Ms. Marcia Peters: Okay. Sorry.

    Walpole Island is the southern-most first nation in Canada. We're located in southwestern Ontario. We're just south of Sarnia, Ontario--

    The Chair: Hence Lambton. Okay.

    Ms. Marcia Peters: We're in between Windsor and Sarnia, right along the St. Clair River.

    The Chair: Thank you. We were all guessing, wildly, getting it wrong.

    Thank you.

    Ms. Marcia Peters: All right. I'm sorry about that.

    My fourth point is that the aboriginal head start program is not a universal program for all first nations communities. Walpole Island applied in 1999 and was not successful due to a minor technicality. This program is currently being considered almost a determining factor in the success of other provincial funding proposals, such as the recent Early Years Challenge Fund in Ontario, for example. If first nations do not have this program, or other adequate federal or corporate funding to match the Early Years Challenge program, their chances are substantially lessened for approval.

    The Speech from the Throne of 2001 states:

(The Government of Canada) will also expand significantly the Aboriginal Head Start program to better prepare more aboriginal children for school and help those with special needs.

    Walpole Island First Nation has been anxiously awaiting a call for proposals on this expanded initiative. Has it occurred? If not, when will it occur?

    My fifth point, in light of the residential school intergenerational impacts that plague our community today, is that the existing Aboriginal Healing Foundation is another program that is not universal to all first nations. People tend to think that this program would not apply to the children, to our babies in the community, but I think it does. If we want to make the lives of our babies better, any healing that takes place in the communities has to address the issues of the parents, who like myself are probably descendents of residential school survivors.

    Every day our babies feel the residual effects through the loss of their parents' parenting and nurturing abilities. Also, this program is time limited, while trauma suffered at residential schools will take a lifetime to heal. More community healing programs, including culture and language programs, are needed.

    According to language experts, there are eight stages to language loss. The current status at Walpole Island First Nation is stage seven, the second stage prior to extinction, where adults beyond child-bearing age speak the language. Stage eight is where only elders speak the language. As each year passes, our community rapidly approaches stage eight, with the passing of our elders.

    My sixth point is that programs and services for children with special needs are by far the most extreme cases of unmet needs. We require a respite home within the community and much-needed program development in all service areas: housing, recreation, health, education, and social services.

    Most provincial programs, such as the preschool speech and language program in Ontario, are not available within the community due to Walpole Island being serviced under the federal jurisdiction. We've been linked with the Sarnia preschool speech and language program, but again, we have to travel 45 minutes to an hour to go to that program.

    There is also a huge gap in services for children aged five to 18. After children turn the magic age of five, suddenly there are no programs for them. Also factoring in the technology of today, they turn to Nintendo 64, Xbox, VCRs, and DVDs to entertain themselves.

    My eighth point is on the lack of transportation. This is another hurdle our parents and children must deal with when trying to obtain access to programs and services within the community. This problem is doubled for those residing outside of the community.

    My ninth point: many times first nations communities seem to be an afterthought when new programs and services are developed. A program is developed, and then the question of “what about the aboriginal communities” arises. They will be fit in after the program has already been planned.

    Point number 10: most first nations lack the technology to keep up. Front-line workers must juggle their schedules in order to meet their clients' needs. When faced with gathering statistics, front-line workers are pulled away from their duties. Families deserve more time for better services.

    My last and final point is that there need to be more opportunities for open dialogue and communication with first nations communities, especially with front-line workers. Why not have a meeting inviting a member from each first nation, as we are not all the same?

º  (1600)  

    What is needed and what could be improved? In order to address some of the above concerns for Walpole Island First Nation, please consider the following suggestions.

    Provide adequate funding based on our growing population. Allow flexibility and lessen restrictions to funding. Flow resources directly to first nations, not to culturally inappropriate agencies outside the community. Provide more funding for housing.

    Make Aboriginal Head Start and the Aboriginal Healing Foundation universal for all first nations in Canada, because it will take generations to reverse the damage caused by residential schools.

    Provide more funding for culture and language programs. Make the aboriginal languages in Canada the first language of this country.

    Follow through with promises announced in the 2001 Speech from the Throne and/or build upon them, for example, Aboriginal Head Start.

    Don't let our children with special needs remain invisible. Provide funding for coordination and implementation of programs to meet their exceptional needs.

    Provide respite homes within first nations communities.

    Provide us with resources for servicing our children and youth aged seven to 18.

    To nix the transportation issues, simply follow through with the points above addressing the housing and financial flow of resources directly to first nations. Make it a priority to include first nations representatives in the planning states of program development.

    Provide more capital dollars in order to purchase newer computers, up-to-date software, etc. This will allow first nations more efficiency in gathering data and statistics to meet government accountability requirements. Greater efficiency overall will allow more time for direct service to the community.

    Don't treat all first nations alike. Offer to speak to each first nation, and don't base it on whether they are deemed successful or not. Less progressive first nations deserve to be heard as well.

    Who should do all this? Who better to offer services to their own community members than a community's own members? We can do it—with more resources and flexibility and fewer restrictions.

    Where to start? Please start by having a follow-up with the various witnesses at this meeting. Take all suggestions to heart, and begin meetings that will build trust with first nations. Begin negotiations to flow funding directly to communities. Work in coexistence with first nations for a healthier Canada, as it was in the beginning.

    Meegwetch for allowing me to give this presentation.

º  (1605)  

    The Chair: Meegwetch to you too. Thank you very much.

    I hope you realize from our persistent asking you to appear before us that we've been following your advice in trying to have this discussion with you, a first-line worker, and with others as well. I am told by our researcher that we've had no less than 35 first nations who have now said they would like to come to talk to us directly. We are deeply grateful when a person such as yourself, who obviously has a ton of things to do, takes time from her schedule and from her family to come to us. We are delighted to have you speak to us directly.

    I'm going to go straight to questions, beginning with Larry Spencer.

    Mr. Larry Spencer (Regina--Lumsden--Lake Centre, Canadian Alliance): Thank you, Mr. Chair, and thank you, witnesses, for coming and sharing with us once, twice, three times, or whatever it's been for some of you.

    Abu, you mentioned that the people who receive these programs feel in general that they're better off. You made that statement. I just got that and maybe not all the context. Could you elaborate a little more on what makes them feel better off?

    Mr. Abu Nazir: Yes. By managing the resources and being given the opportunity to reallocate those resources based on priorities they have determined themselves, they felt that they were able to make the best use of those resources by being able to develop their own community members and infrastructure. They felt that by doing that they were one step further towards self-determination. It does not mean they have all the resources they would like, but they felt they did a better job than the federal government would have done, or at least that they weren't doing it any worse.

    Mr. Larry Spencer: That leads me to the next question. Marcia, you mentioned Brighter Futures and a whole list of other programs--I couldn't write as fast as you could talk. Who leads those programs? Let's take, for example, the aboriginal head start program, which is key for you. Who is generally involved in leading that? Would it be your people, or are there people hired and brought in to run those?

    Ms. Marcia Peters: We would be. As I said in my speaking notes, we applied back in 1999 for that program. We received funds to develop our proposal, and we hired our own community members to conduct a needs assessment. So I can't say that the whole experience was not good because we did get some valuable information from that needs assessment. After we submitted our proposal, it turned out that there was a technicality. The entire program was developed in collaboration with the different services on Walpole Island.

    Mr. Larry Spencer: You mentioned that you've operated for one year under the new model. Can you highlight some of the differences between how it was before and what you're now calling the new model?

    Ms. Marcia Peters: Most of the social service programs are provincially funded. We had maybe eight different programs running in isolation, and the restructuring of social services brought the common services together into four different units. I work in the community development unit. There is a children's services unit, a child and youth services unit, and a family violence unit.

º  (1610)  

    Mr. Larry Spencer: In other words, your new model answers the problem you talked about as the flow of resources in silos. You grouped some together and then allowed discretion as to how much money went to each area.

    Ms. Marcia Peters: Right. It decreased the amount of administration.

    Mr. Larry Spencer: Does it give you more flexibility in spending different amounts in different ways?

    Ms. Marcia Peters: I would say so, yes.

    Mr. Larry Spencer: Do I have time for one more question?

    The Chair: Yes.

    Mr. Larry Spencer: What qualifiers make it so difficult to qualify for the head start program?

    Ms. Marcia Peters: Are you asking me why we did not get it?

    Mr. Larry Spencer: Yes, you or many others who didn't.

    Ms. Marcia Peters: It had to do with a signature of one of our people.

    Mr. Larry Spencer: Today, in applying for a passport I almost goofed by sending one picture instead of two--those bothersome details.

    Ms. Marcia Peters: There's an underlying issue there as well, and I don't mind sharing that. One of the funding sources Walpole Island received in 1991 was under the better beginnings, better futures program. I'm not sure if everyone here is familiar with that. Walpole Island is one of eight Better Beginnings sites in Ontario. We're the only first nation. So behind the scenes we're kind of wondering, because we've heard it before from one of our own local ministry people. Thank goodness he's not in that position any more. When the healthy babies/healthy children program started, he said, “You don't need that program; you have Better Beginnings”. It was like, you have Better Beginnings so you don't need anything else.

    We don't know the real reason we didn't get the head start program. It was a signature, but we're kind of thinking maybe...

    Mr. Larry Spencer: I'm sure many others have not received the program if it's limited. I was just curious if you knew any of the general difficulties, whether certain ways you had to qualify were difficult for you, other than dotting all the i's and crossing all the t's.

    Ms. Marcia Peters: They didn't share any of that with us. They just said it was the lack of that signature.

    The Chair: As we have Abu here, maybe he could find out for you.

    Mr. Larry Spencer: I was just going to ask him that. He's looking sheepish.

    Some hon. members: Oh, oh!

    Mr. Abu Nazir: I'm dealing with the funding arrangements, but I'm not familiar with the process for funding with whatever part of the department you were dealing with.

    The Chair: Perhaps afterwards you could have a conversation.

    Mr. Abu Nazir: Yes, possibly.

    Ms. Marcia Peters: It was Health Canada.

    The Chair: Oh, I know it was. It would have to be, if it was Head Start.

    Mr. Abu Nazir: Yes, it would have to be, but I'm not sure of the processes.

    The Chair: Why don't you two chat afterwards?

    We're just here to bring you together to try to solve problems.

    Madame Guay.

[Translation]

    Ms. Monique Guay (Laurentides, BQ): Thank you very much, Mr. Chairman. Thank you as well to the witnesses for meeting with us.

    I have a question for Ms. Peters. A number of first nations representatives spoke to us about their community centre and about how it provides services to members of the community through Health Canada programs. However, some first nations do not have a community centre and cannot offer the same level of service. Would you care to comment about this?

    Let me give you an example. In Quebec, the CLSCs offer specific programs for aboriginals and can provide a wide range of services to aboriginals and to their families and children if these services are not available in their own community.

    How do you feel about this and how can we help first nations that don't have a community centre to apply for and use federal government program funding?

º  (1615)  

[English]

    Ms. Marcia Peters: I guess I would think about what capacity those first nations have. In human resources, do they have the expertise to run those programs? If they do, then I don't see what's holding these back. They probably just need the resources, or maybe they need a building. Among first nations, even in our own community, we have a few nice buildings, but there's one program that runs out of a 70-year-old church rectory. Every year there's maintenance and whatnot that has to be done on the building.

    I believe all first nations should have access to programs.

[Translation]

    Ms. Monique Guay: We know their goal is to provide services to their own population in a fully autonomous manner and it's important that they achieve it. Moreover, in Quebec we are extremely supportive of their efforts in this regard.

    The provinces also administer a number of programs, in addition to federal programming. Are these various programs well coordinated? Perhaps you would like to comment on that as well.

    So as not to confuse you, I'll reserve my other question until later.

[English]

    Ms. Marcia Peters: In various aspects, when funding comes from the federal government.... For example, there are a couple of parenting programs that are run in our community--Nobody's Perfect and You Make the Difference. We work in partnership. We have staff from our children's services unit, and their funding is provincial. The Bkejwanong Children's Centre is the day care centre. There is a staff person from their staff who also is trained to do that parenting program. Then we have a couple of health representatives. So we work in partnership in various initiatives, but on a much larger scale we're still trying to pull it together.

[Translation]

    Ms. Monique Guay: I saw that you have a fairly lengthy list of demands. Early, you read the items on that list to us. Realistically, we can't meet all of these demands on the spot. That's for certain. It would be dishonest for us to tell you otherwise.

    Should some of these demands be given priority consideration? What are your top priorities at this time so that we can focus on them in particular in our recommendations?

º  (1620)  

    The Chair: May I just say something?

    Ms. Monique Guay: Go ahead.

    The Chair: Remember that we're focussing on children from birth to six years of age. What are the priorities for this age group?

    Ms. Monique Guay: Precisely. This is the focus age group in terms of your list of demands, and our recommendations.

[English]

    Ms. Marcia Peters: When I had the opportunity to come here... I'm dreaming, and I'm dreaming big. If I have a chance to say something, I'm going to.

    The Chair: Go for it.

    Ms. Marcia Peters: That's why my list is so...I know it asks a lot, and I'm not expecting it to happen next week, or next year even--maybe 10 years.

    Some of these things... It's hard to put it in perspective that way. There are much huger issues that could solve a lot of the smaller things for us.

[Translation]

    Ms. Monique Guay: However, you work in this field, specifically in a community centre. Children in this age group, that is from birth to six years of age, must have some urgent, pressing needs. There must be areas on which we should be focussing our immediate attention.

    The Chair: We also need to be concerned about their parents.

    Ms. Monique Guay: Obviously, because when we help the parents, we also help the children.

    If you had to list your priorities... Given your first-hand knowledge of the situation, you know, unlike us, what it urgent and what needs to be attended to. We could include these references in our report and make an immediate recommendation in order to get things moving on this front.

[English]

    Ms. Marcia Peters: I would say the children with special needs are the most lacking in our community right now. We also need to address issues related to our language loss. And right now there isn't anything such as community healing programs that would assist our families to heal themselves after the residential school experience. Our community has received a couple of small grants from the Aboriginal Healing Foundation.

    I guess different first nations are on varying levels. I think Walpole Island is just a little bit ahead of some other first nations in their acknowledgement and general awareness through the community. We have I think five generations who have been through residential school. About 400 of our community members from my father's era were taken to residential schools as children. There's a lady on our band council right now, our social services committee rep, who is a residential school survivor, and she was taken at the age of four. My son is four. That just blows me away.

    Those are three really high priorities, I think.

[Translation]

    Ms. Monique Guay: Thank you very much.

[English]

    The Chair: Thank you very much indeed. It's extremely helpful for the work we're doing. I'm sure we'll want to take advantage of our meeting today to do some follow-ups.

    I have on my list Mr. Tonks and then Ms. Neville.

    Mr. Alan Tonks (York South--Weston, Lib.): Thank you very much for both your deputations.

    I'm sorry if I missed the point, Ms. Peters, but do you have a transfer agreement through the Ministry of Health?

    Ms. Marcia Peters: Do we? I don't know.

    Mr. Abu Nazir: No, they do not. They have just completed their pre-transfer planning--the community health plan they've just produced. Once that's reviewed and approved, it is expected they will be in transfer, probably later this year.

    Mr. Alan Tonks: All right.

    From your perspective, then, Mr. Nazir, would the problems that have been outlined by Ms. Peters involving gaps in service and so on...

    The Chair: Mr. Tonks, I don't mean to interrupt you, but I know that our guests, riveted though they are by our discussions, have to leave.

º  (1625)  

    Mr. Alan Tonks: You mean I offended all of them at once?

    The Chair: The moment you started, that tore it. We got along very nicely with them, but now they're all going to leave.

    So we say goodbye to you.

    Mr. Alan Tonks: I've cleared a room faster than this, believe me, in the past.

    The Chair: He sort of has the magic touch, doesn't he?

    We thank you all for coming. We hope you've enjoyed this. If you want to know what happened, go to the Internet and follow the transcript.

    Mr. Alan Tonks: Some of us will be at the dinner tonight.

    The Chair: Oh, we're seeing them tonight.

    So we'll see you later.

    I apologize for the interruption, but I thought it was perhaps easier to do it that way than just have them completely walk out in the middle of your scintillating and....

    Go ahead.

    Mr. Alan Tonks: I think Mr. Nazir knows where I'm going with the line of questioning.

    Would you like to respond?

    Mr. Abu Nazir: Yes. Going to a transfer agreement would address some of the issues you raised, but the bigger issues are systemic in nature. It's the way the government provides funding and the multi-faceted approach, where every department provides their own funding--maybe a piece of the same program sometimes.

    What we have is the transfer agreement. Yes, we give them the flexibility to deal with their human resource development, but only within the context of the resources Health Canada provides.

    The challenge is how they can integrate, at the community level, the programs that relate to each other that they may get from the provinces or other departments and streamline this, almost like a single-window approach, where from the federal government they get the resources and then work within some accountability framework to deliver the service and report back.

    Some first nations across the country have in fact done it, but what they're facing is the administration of reporting back separately to the individual departments. We have communities that are in transfer. They've integrated their health and social programs and have done it very effectively, and they report back to the individual source of funding, the departments that do it. But it comes at the cost of an administrative burden.

    If you do integrate it, you're integrating the program delivery. What the first nations would like to do is integrate the funding, and the data reporting, and all of these things from the different sources, so that they can move resources around.

    Right now, with our transfer program, they can move the money around within all the Health Canada--

    Mr. Alan Tonks: It's like a global budget.

    Mr. Abu Nazir: Right. Transfer communities who have been in transfer for, say, eight or ten years are at a different level now. They want to deal with health policy. They want to deal with funding from other departments and are pressuring departments to work in the same mode. They want to integrate the funding similarly to the reporting. That's what we're faced with.

    Mr. Alan Tonks: You'll recall, Mr. Chairman, this whole process of late was embarked upon in search of this dream for the perfect model. We thought when we heard about the transfer agreement at our last meeting we had just verged on that recently.

    Mr. Abu Nazir: And just for your information, we have engaged with Indian Affairs--because we're dealing with the same people--to have a common agreement, and we are there. We have an agreement where both Health and Indian Affairs programs can be integrated.

    But we face another systemic issue, that when we get programs approved by Treasury Board the approval is still within house, and they're not allowing us to move programs across departments. I think the departments and first nations are willing to do it, but the challenge is how to change it at the higher levels, given the way we operate as a government.

    Mr. Alan Tonks: It seems to me we're trying to develop a paradigm that would be inclusive not only of the clustering of ministries, but would also require some kind of agreement with the provinces.

    I guess my question would be, is there to your knowledge a model that has integrated programs under provincial jurisdiction--more like what has happened in the province of Quebec, I believe?

    Mr. Abu Nazir: Integration in the sense of the first nations that are doing it, in terms of delivering the programs, not integration in terms of the reporting and financial authorities. That's what is missing.

    Where it's being done is in self-government. Once you get to that level, it's more of a global budget and resources from the province fastened together. So it's being done only at that level.

    To do that at the administrative level of contribution agreement, first of all, we have to have the will to do that and quite good cooperation between the provinces and the federal departments of health to make it happen. It could happen, but everyone has to define the requirements and be willing to do it.

º  (1630)  

    Mr. Alan Tonks: Okay. I have one more quick question, if I may.

    Under the transfer agreement, Ms. Peters referred to the problem of contracted work that is outside of the community and doesn't necessarily meet the needs of the community, either in physical needs--requiring busing and that kind of thing--or program development, which is outside of the spirit of the agreement.

    Within the agreement--and we're just talking health now--is there a problem with respect to contracted services, or are they under the accountability of the first nations community they serve?

    Mr. Abu Nazir: Under a transfer agreement, the first nation will have their own accountabilities and processes to contract out services, because with transfer, they have the ability to do that because they'll be working with a global budget. So the accountability is really, from our point of view, whether they have the conflict of interest guidelines and all the things that a good organization would have in place to manage their own affairs. That's what we ensure they have in place, but they will be able to contract out once they're into that mode of delivery.

    Mr. Alan Tonks: I see.

    Thank you, Mr. Chairman.

    The Chair: Thank you very much. I think that was an extremely useful line of questions. Great things are rattling around in our brains in terms of what might be in our report.

    Ms. Neville.

    Ms. Anita Neville (Winnipeg South Centre, Lib.): Thank you.

    First let me begin by thanking both of you for very excellent presentations.

    Madame Guay asked you, Ms. Peters, a number of the questions that I was going to ask, but I'm just going to build on those a little bit.

    I'm concerned about the gap in services, where the federal government and the provincial government don't meet. You cited the example of children with special needs being an extremely urgent issue. Do you have any access to provincial services for children with special needs, or is that just not possible for you?

    Ms. Marcia Peters: Speaking from my own experience, my son having Down's syndrome, for most of the services like speech therapy, audiology, or physiotherapy, the whole thing, I had to go to Sarnia for those until...

    My son was in day care, and the physiotherapist would come there. They have a resource teacher who they contract from another agency in Sarnia, and I know they're not pleased with that agency. They're not seeing eye to eye culturally and in appropriateness and in effective...

    It seems that there isn't enough. They're not giving enough. She comes maybe half a day per week. They need more time there.

    Ms. Anita Neville: But do you have access to the provincial system for the services for your child?

    Ms. Marcia Peters: Can you give me an example?

    The Chair: When you go to Sarnia, for example, is that provincial?

    Ms. Marcia Peters: That's provincial.

    Ms. Anita Neville: It is provincial. So you do have access to the services—

    Ms. Marcia Peters: Outside of the reserve, yes.

    Ms. Anita Neville: —off reserve.

    Are there instances where you don't have access to the provincial resources, not only for children with disabilities but other health issues that would be needed on reserve?

    What I'm concerned about is the harmonization of services between the federal government and the provincial government. I want to know what the gaps are that are not being met.

    Ms. Marcia Peters: I'm married. There are some single parents out there, and some of them are unemployed. I am employed and I have a car. I can go to my appointments or do whatever I have to do to go to Sarnia. There are some families who don't have vehicles, and to get services outside of the community takes a lot of work. Sometimes I think parents just--

º  (1635)  

    Ms. Anita Neville: Give up.

    Ms. Marcia Peters: Yes.

    If everything was available to us on the first nation reserve it would be so much easier. I don't know if that really answers your question. I'm trying to think of what you're asking me.

    Ms. Anita Neville: What I'm trying to ask, and you are answering the question, is are there people who are not getting the required or necessary services because of the jurisdictional issues, either because they live on reserve, don't have the capability, or because the province.... In another setting we heard stories of parents of a child with disabilities--

    Ms. Marcia Peters: Yes, that's correct.

    Ms. Anita Neville: --having to give up the custody of their child in order that their child gets the service that's required. I'm trying to probe a little bit to see what some of the jurisdictional issues are.

    Ms. Marcia Peters: That's a reality on our first nation reserve as well. There's a worker in the children's services unit who has been working with the families of children with special needs in the community for quite some time now and she was a big resource in my life when I had my son. Because we're both in social services and we're aware of all of the issues going on in the community, I'm aware that that is happening in our community as well.

    If we could have our own respite home on the first nation reserve, that would alleviate a lot of the stress. I'm thinking of one lady in particular who is a single mom of a child who has cerebral palsy. She's in a wheelchair and she's unable to talk, so it requires 24-hour care. I think she's allowed respite maybe three times a year, and she has to take her daughter to Chatham or somewhere outside of the community--again, to a non-native environment and everything that goes along with that.

    Ms. Anita Neville: On a slightly different line of questioning, Madame Guay asked you about your priorities and you identified special needs as one of the highest needs, and I think that was a bit in response to the chairman's direction for the under six. I'm looking at your list of ten wishes, or ten high needs, and I'm wondering how critical the issues are related to the population growth and the lack of an increase in funding.

    How significant is the population growth? I assume your funding is at the same level, not growing. How is that affecting resources, and would you put that as a high priority? That's more of an umbrella than a specific issue.

    Ms. Marcia Peters: A couple of years ago, when we did the aboriginal head start proposal and the whole needs assessment that went with it, we had ten children diagnosed in that age group with special needs—and that was three years ago. So it is growing; there are more special needs.

    Thinking back to how it was worded in the actual proposal, these ten children who were diagnosed as having special needs did not include identified fetal alcohol syndrome—

    Ms. Anita Neville: That was my next question.

    Ms. Marcia Peters: —or fetal alcohol effects. It didn't include that, and I'm told there is a high number in our elementary school with that issue.

    Ms. Anita Neville: How did the refusal of funding for the aboriginal head start program trigger the lack of funding for other programs? I don't understand why that happened.

º  (1640)  

    Ms. Marcia Peters: My knowledge of this... I can't say it is a definite reason. In my experience doing the Early Years Challenge Fund proposal, the aboriginal community coordinator had told me... Originally, when they did their first call for proposals in August 2001, it was stated there that aboriginal communities did not have to list any matching contributions, and then it changed. They had changed it in November 2001 to where apparently we had to have matching funds in the community from federal or corporate sources.

    Now, in my talking with that person she brought that to my attention, and I did up a chart. As I said, a lot of social services are provincially funded, and over half the partners that were listed in our proposal were provincially funded. She contacted me back, and she said we could not use them; we had to have federal or corporate sources to match, and I said okay. Somewhere along the line I heard that another first nation near Walpole Island was applying for the same program, and they had Aboriginal Head Start, so I brought that to her attention. I said, so are you saying that communities that have an aboriginal head start program, which is a federally funded program, have a better chance? She didn't say yes or no, but I think the light bulb went on, and she said, oh, I'll get back to you. She got back to me and said, oh, no, no, no, never mind that; just send your proposal in.

    The Chair: I know I'm not a witness, but I think I can explain that. It is simply that in Ontario the current provincial government has this thing called the Early Years Challenge Fund, and the ideological assumption is that there needs to be 50-50 funding: 50 cents of non-provincial dollars for every 50 cents of provincial dollars.

    What is extraordinary is that for this Ontario early childhood development fund of $114 million they've actually taken $20 million of our money--federal money--and subjected it to those conditions as well. Frankly, it's nuts, but that's another issue. I think you're absolutely right. I think your reading of the scene was quite right, Ms. Peters.

    Let me just ask a couple of questions. First, this is to Mr. Nazir, and I want to understand.... There's a page in your presentation called “Continuum of Control”, and it relates as well to the following page, which is called “Transfer Status”. At the top of the list is “Self-Government”, which means aboriginal communities run their affairs entirely by themselves. I would then understand, because it's listed as a continuum, that the next best thing to have if you want more control is something called a “Health Services Transfer Contribution Agreement”, which has, I assume, less conditionality attached and which applies to 276 first nations and seven Inuit communities, which is on your next page.

    Then, a lesser good thing to have--I assume there's more conditionality, there's less money, or there's something--is this “Integrated Community-Based Health Services Contribution Agreement”, and then there's less than that. And finally you just do it, right? That's the last one.

    Can you tell me, what is the difference between the transfers and the integrated agreements? What's the distinction there?

    Mr. Abu Nazir: The difference with an integrated agreement is that they're given a lower level of funding for a health management structure than if it were a transfer, and they deal with less planning. Meanwhile, a transfer deals with comprehensive health planning for the whole community; they get a lot more money to deal with overhead and other costs, and they have more flexibility in terms of moving their money around. In integrated arrangements they can only move money around with certain programs, while a transfer is the whole ball of wax they have under an agreement, where they move money around and set their priorities. The most important one is that with the transfer they can redesign their program based on their changing priorities. With an integrated agreement you're still delivering that program based on the government framework for each individual program they're delivering.

º  (1645)  

    The Chair: Between the two different kinds of communities--the 276 that are in transfer and the 140 that are integrated--is the decision to be in one or the other the community's decision or your decision?

    Mr. Abu Nazir: It's a combination. First of all, I said in my presentation that the community must decide themselves if they want to go into transfer, so it's their decision. There are a number of communities that have the capacity already but wish not to go into it because they want the federal government to continue delivering certain programs directly.

    The second issue is that they have to have the capacity to do that. That's why we go through about a year or nine months of planning, for them to develop their infrastructure and so there's an assessment of their capacity. If they don't have the capacity, they stay with the integrated approach.

    There are smaller communities that don't even have that capacity. They would be in the next one down, which is basically a single funding agreement to manage a program through very strict rules.

    The Chair: Are there ever disputes at the end of the nine-month process, where a community thinks they can do this and you don't think they can? Does it generally work out that you come to a bit of an agreement, that you all agree that they either have the capacity or they don't?

    Mr. Abu Nazir: Yes, there is generally agreement that if there are some weaknesses, we would give them more time and support to fix those problems. Usually it's the decision of the band councils whether they want to proceed or not. That's the main reason for not proceeding.

    The Chair: I want to come back to dreaming big because I was struck by a comment Ms. Peters made, which was the afterthought comment. I think it's the wild ambition of this committee, within what it can do... I very much want to echo the point of Madame Guay that unfortunately we have not been given the mandate to completely redo the relationship with first nations. Our focal point, by definition, is children and youth at risk. We are initially concentrating on this younger population because we just have to start somewhere, and we think starting at the beginning makes sense.

    Our dream would be to come up with a plan that would be not the afterthought, but the forethought. In our ideal world, we would like to encourage the federal government, perhaps beginning with certain communities--God forbid the word “pilot”, but you know what I mean--in different conditions and in different provinces that would be willing to work with the federal government and with the provincial government--I think this is really crucial--to integrate, with extra money from us, all those services for from conception to six, and for the parents of those. Obviously, by definition, children do not exist in a vacuum, particularly for all the reasons Ms. Peters has alluded to, including the terrible psychic damage caused by residential schools.

    When I look at the list of provincial or federal programs Ms. Peters began with, from child care to the national child benefit, what we're thinking here.... I want to try this on. Mr. Nazir, you're allowed to dream too. I want you to know that just because you're a civil servant doesn't mean you're incapable of dreaming.

    It takes into account what you were saying. What we want to be able to do, in a sense, is to pool all the program money, not simply your money so that it gets to a transfer contribution agreement. We want an agreement that essentially would take all the federal dollars, whether it's under Justice, DIAND, or HRDC for child care, and say that after appropriate consultation, we want to develop a capacity on reserve that is culturally sensitive and provides a continuum of support for everybody, from the moment they get pregnant to the moment the child gets into the school system. This program would deliver the appropriate mix for that community, fashioned according to the demographics and challenges.

    We would attempt to make sure the provincial stuff is integrated too. We're going to have more success or less, depending on the nature of the provincial government. We would find a way of dealing with Treasury Board reporting requirements. Indeed, we might want to talk to the Auditor General and say that it's only when we pull this stuff together on the ground, with appropriate reporting mechanisms and data collection, that we can actually make sense of these silos. It shouldn't be up to the community to become experts in grants, for goodness' sake, in trying to do our work for us.

    If we were to recommend this as a general approach and then encourage the federal government and the provincial governments, where we can, to get their feet wet, work together, do it with on-the-ground service delivery, is this a dream you would share? Does this make sense to you?

    I'm going to start with Ms. Peters because she's on the ground, and then I'm going to come back to you, Mr. Nazir, so you're not off the hook.

º  (1650)  

    Ms. Marcia Peters: It would be a good start.

    The Chair: We can only start. Would it be a move in the right direction?

    Ms. Marcia Peters: I would think so, yes.

    Getting back to what Anita was asking around federal and provincial programs, that is a major issue on the reserve. In my notes, the example was the preschool speech and language program that is a provincial program in Ontario. Just over the bridge, on the mainland, there is a little town called Port Lambton. They have this program called SoundStart. We asked them if they could come once a week to the reserve--

    The Chair: Walk across the bridge, basically.

    Ms. Marcia Peters: --and offer that program on the first nation. And they can't. They said they can't because we're under federal jurisdiction.

    The Chair: But you wouldn't have a problem if they walked across the bridge and delivered the program in your place, would you?

    Ms. Marcia Peters: Well, we would much prefer to have our own speech pathologist from our own culture, but that's probably down the road yet.

    The Chair: So in the meantime, that wouldn't....

    Ms. Marcia Peters: No, it wouldn't.

    The Chair: Mr. Nazir, I'd like to know your point of view, sitting where you are, trying to make sense of all of this. You've certainly given us the big picture, the systemic challenge. Can you think of ways--because you're the funding guy--sensible people of goodwill at our end here, in the federal government in Ottawa, could actually pull off this vision?

    We're interested in you because you have paved the way, as we understand. You've had the experience. We're saying why shouldn't we build on that experience, and maybe it could leverage off the health part? Why not? Maybe that's the base, and we'd build in the developmental parts and worry about kids with disabilities and all the rest of it, but essentially work off the existing health structure, the way they do in Quebec. How does it strike you? What warnings would you give us?

    Mr. Abu Nazir: Mr. Chair, I would like to say that the dream you've described is not a new dream. There are many in government who have been saying this for years.

    There are two aspects. Putting aside the federal-provincial jurisdiction issues, that you'd have to deal with the province for aboriginal health, just within the federal government there are things that could be done right now that wouldn't take a lot of doing to make some inroads in this area. There are some things that are systemic, which you would have to deal with at senior levels in government.

    But I think it has to be up front. Immediately after a program is approved or the government announces there's a new program with funding is when the key decisions have to be made on how that program will be delivered--before it gets into the hands of the people who design the framework and begin delivering it. That direction has to be given right up front. This is what we would like to see happen. Because once it gets into the hands of the people who have to design the framework and implement it, you're following the way the bureaucracy works and the way people think from department to department, or divisions within a department.

    Take early childhood as an example. When the government announces it, right up front is the time to say this is how we would like to see that program happen. Then the various departments and authorities will come into place to make it happen. But the direction has to be given by senior levels in government that this is how we want to operate.

    Then we have another level, on the individual program side of things, right now. Deputy ministers and ministers have to say this is the way we want to change things, and the bureaucracy has to respond to find the way to do it. I don't want to go through them now, but there are a number of administrative things...not really a hindrance...but just a willingness, openness, and trust to do it, rather than every department, division, or directorate holding on to their fiefdom, if you like.

º  (1655)  

    The Chair: Could you tell us a little bit about the low-lying fruit? That is, you said there are a number things, initial victories, that we could have here without going to the highest levels. Could you give us a couple of “for instances”?

    Mr. Abu Nazir: For instance, we have what we call a Canada-first nations agreement. It's a joint agreement between Indian Affairs and Health Canada. If a first nation wants to have one agreement with both departments' programs in it, they can. We have a few of those out there already.

    In spite of the integration of one agreement and the funding, still each department tends to hold onto its own accountabilities and separate reporting, and they are different. Why not converge it and make it transparent to the first nation? That can be done internally right now. One department is saying, “If I have a savings in my program, I'm sorry, you can't use it.” The first nation cannot use it for the other program. But I don't see anything that is breaking any laws nor anything to say you can't do that, because it's still relating to the health of the first nations.

    For example, housing--in Indian Affairs--has an impact on health. Or take Environment--environmental issues. If you have savings in one area, why can't you do something in one area or the other? It still impacts health. Those are things that just take a willingness to do.

    The Chair: It's very encouraging. I suspect we would almost want to have an off-line conversation with you, and that may be what the researcher will do, that would basically tell us who we needed to talk to, or the kinds of recommendations we needed to make. We may need a little technical help from somebody like you as we think about a report, because we're trying to work towards a common purpose.

    You understand completely what we're up to here. I think you've had the advantage of being an insider who could see some obvious things we could do, and it would not be violating rules of accountability or anything else. We need to find some models where people have done it in other parts of the civil service. So we may want to have, as I say, an off-line conversation about this.

    Yes, go ahead.

    Ms. Marcia Peters: Have you all taken a look or thought of looking at the Better Beginnings, Better Futures model?

    The Chair: Yes. Part of the irony about this is that the official theology of the province of Ontario now is very much a kind of integrated model at the community and all the rest of it--it's kind of like child care.

    I think at one point in your remarks, Ms. Peters, you suggested there was almost a penalty: “Oh, you've got this one; you don't need that one.” On the other hand, there was the alternative, which is: “Ah, we're not going to give you this one unless you have that one.” It seems to cut in both directions, which is, at the very least, confusing.

    It would seem to me that when we have programs or model communities--there are five communities in Ontario that have been selected for special attention, including Ottawa-Carleton, for instance--the federal government would be well advised to double up and say, “What would happen to this experiment if we all got our act together and worked on the ground with the community and had a seamless web of services that covered everybody and weren't in contradiction with each other?” I think the taxpayer wouldn't find that a totally startling concept, and people in the communities wouldn't either.

    We try to keep an eye out for this kind of thing. What we're trying to figure out is ways, from our end--without being intrusive or inappropriate or not respectful of provincial jurisdictions--that we can actually get the job done on the ground, so that things make common sense, so that it really relates to the sort of everyday experience you were telling us about on Walpole Island, where you probably have enough children with special needs that it makes sense to deliver the program on the ground.

    There's a kind of critical mass of those kids, and you know who they are. We're trying to find ways of overcoming the natural desire to track the dollars and make sure they're properly spent, but we know it's got to be more effective when these efforts are integrated, and that the benefits will come from that integration and from being able to put more resources for special needs kids in certain situations, and more towards fetal alcohol syndrome in the other, and getting the balance right. It can only be done by knowing the situation on the ground.

»  (1700)  

    Ms. Marcia Peters: And it would be a good example to some communities. In Walpole Island's case, in some instances the funding silos, the funding coming from different sources, has created some division.

    The Chair: Well, that's right, and that's entirely ridiculous. I mean, why should you actually be working at cross-purposes when you could be working in a reinforcing, cooperative way?

    I'm not going to say what the final report will say, because I don't know, but I think we're kind of intrigued by this notion of building out from health centres, because there's actually, as it were, an installed base. We have a precedent for devolving money and authority to first nations. A lot of what we're talking about is in the broad area of what we'll call developmental health, and I would include child care, early childhood care and learning, as part of the package, as it is in Quebec. We need a governance structure that everybody feels comfortable with and that is transparent but not burdensome. Let's build on our successes.

    The reason we were so keen to hear from Mr. Nazir was that we got a bit of a feel for what that might look like, and we're getting a bit more of a feel for how we could push that model out.

    I think it has been remarkably helpful to have the two of you here to give us the macro and the micro, just to see how these things mesh. I don't know if there are any other comments or questions from members of the committee or indeed from you, any final thoughts to warn us about the direction in which we're going or to encourage us, but we're certainly pleased by what we've heard from you today. It has been extremely helpful.

    We're going to stay in touch, of course, because that's one of your recommendations. We read you, we hear you, we're glad you're here, and we will stay in touch.

    On that note, it being 5 o'clock, I will end the meeting.