Proceedings of the Standing Senate Committee on
Aboriginal Peoples
Issue 15 - Evidence - April 24, 2012
OTTAWA, Tuesday, April 24, 2012
The Standing Senate Committee on Aboriginal Peoples met this day at 9:30 a.m. to examine and report on the evolving legal and political recognition of the collective identity and rights of the Metis in Canada.
Senator Gerry St. Germain (Chair) in the chair.
[English]
The Chair: Good morning. I would like to welcome all honourable senators and members of the public watching this meeting of the Standing Senate Committee on Aboriginal Peoples. They will either be watching on CPAC or possibly on the web.
I am Gerry St. Germain from British Columbia and I have the honour of chairing this committee. The mandate of this committee is to examine legislation and matters relating to the Aboriginal peoples of Canada generally. Today we will continue to explore Metis issues, particularly those relating to the evolving legal and political recognition of the collective identity and rights of the Metis in Canada.
The early meetings on this study have consisted of briefings from various government departments who have provided us with information including facts on current programs and services, the status of Crown-Metis relations and general statistical information and current legal issues, among other things.
This morning, we will hear from representatives of Health Canada.
[Translation]
Before we hear from our witnesses, I would like to introduce the committee members in attendance this morning.
[English]
There is Senator Lovelace Nicholas from the province of New Brunswick, Senator Campbell from British Columbia, Senator Munson from the province of Ontario, Senator Raine from British Columbia, Senator Brazeau from Quebec, and last but definitely not least is Senator Demers from the province of Quebec.
Members of the committee, I would like you to help me in welcoming our witnesses from Health Canada, Kathy Langlois, Director General, Community Programs Directorate, First Nations and Inuit Health Branch. Appearing on behalf of the Public Health Agency of Canada is Marla Israel, Acting Director General, Centre for Health Promotion and Chronic Disease Prevention Branch.
You have a presentation, I presume. Ms. Langlois, you have the floor. Following your presentation, I am sure there will be questions from senators.
Kathy Langlois, Director General, Community Programs Directorate, First Nations and Inuit Health Branch, Health Canada: Thank you very much for the opportunity to address the committee. I will be making remarks on behalf of myself and my colleague. I am pleased to be joined by Marla Israel from the Public Health Agency of Canada.
The important work that this committee is undertaking focuses on the collective identity and rights of the Metis in Canada, including access to services provided by the Government of Canada. With this in mind, my role here today is to discuss the Health Canada programs and services that are available to Metis.
Through the First Nations and Inuit Health Branch, Health Canada provides or funds health programs and services to address the significant health risks faced by First Nations and Inuit communities and individuals. This work is carried out in collaboration with key partners, including provinces and territories, who are the providers of insured health services for all Canadians. Health Canada also works in partnership with First Nations and Inuit with the goal of supporting effective, sustainable and culturally appropriate health programs and services that contribute to improved health outcomes for First Nations and Inuit.
Based on past policy decisions, a small number of Health Canada's programs are accessible to Metis.
In Budget 2005, the federal government provided $700 million in funding over five years for a number of programs, including the Aboriginal Diabetes Initiative, the Maternal Child Health program, the National Aboriginal Youth Suicide Prevention Strategy, Aboriginal Head Start programs at both Health Canada and the Public Health Agency of Canada, the Aboriginal Health Human Resources Initiative and the Aboriginal Health Transition Fund, now called the Health Services Integration Fund.
Based on the promising outcomes seen during the first five years of these programs, Budget 2010 provided $730 million in funding to extend their mandate for an additional five years to the end of fiscal year 2014-15. Metis continue to be eligible to access some of these programs, and I will now go into a little more detail on that point.
From 2005 to 2010, funding was provided to support Metis involvement in the Aboriginal Health Transition Fund, specifically through an investment of $3.6 million to fund five projects led by affiliate organizations of the Métis National Council. These projects were led by Metis people and focused on better understanding Metis health needs, increasing Metis awareness of available provincial health services, data collection and analysis on Metis health, and better health policy development for Metis.
From 2005 to 2010, through the Aboriginal Health Human Resources Initiative, Health Canada partnered with the Métis National Council to provide over $8 million for bursaries and scholarships specifically targeting Metis students. The Aboriginal Health Human Resources Initiative was renewed in 2010 and will provide $10 million in bursaries and scholarships between 2010 and 2015 for Aboriginal students pursuing health career studies, including Metis students.
Metis health issues have been addressed in the important areas of health promotion and disease prevention.
From 2005 to 2010, the Metis, Off-reserve Aboriginal and Urban Inuit Prevention and Promotion Program of the Aboriginal Diabetes Initiative funded 60 projects to support diabetes health education and awareness, skills development, community action and supportive environments. A total of 51 of these projects were accessible to Metis persons over the five-year period with total funding of over $11 million.
Currently, the Aboriginal Diabetes Initiative continues to support 28 health promotion and diabetes prevention projects through the initiative's Urban First Nations, Inuit and Metis Diabetes Prevention Stream. Metis are able to access services from 25 of the 28 projects, with total funding of $5.25 million.
In total, Metis were eligible to access funding of approximately $24 million through Budget 2005 and going forward to 2015 will be eligible to access funding of approximately $15 million through Budget 2010.
It is important to point out that Health Canada is not the only federal organization that supports health-based programming for Metis. There are a number of programs and activities administered through the Public Health Agency of Canada that benefit Metis along with other Aboriginal people.
For example, the agency funds a number of children's programs that can be accessed by Metis children and their families, including the Community Action Program for Children, the Canada Prenatal Nutrition Program and the Fetal Alcohol Spectrum Disorder Initiative.
In addition, the agency spends approximately $332 million per year through the Aboriginal Head Start in Urban and Northern Communities Program to support early childhood development activities, and Metis are eligible to access those services. Collectively, these programs support over 120 projects that offer specific services to Metis children.
In closing, I hope that this brief overview will help inform the work of this committee in regard to the health-related activities Health Canada has undertaken in collaboration with Metis. Improving the health of Aboriginal people in Canada is a shared undertaking including all levels of government, with provinces and territories being the primary provider of health services to Metis.
Thank you. I am happy to take your questions.
The Chair: Thank you, Ms. Langlois. The first question I have is in regard to diabetes. Do you have specific information as to what level the Metis are subjected to diabetes as compared to the general population as a whole?
Marla Israel, Acting Director General, Centre for Health Promotion, Public Health Agency of Canada: I have that information for you. Thank you for the question.
In Canada, the rate of diabetes for non-Aboriginal Canadians is around 5 per cent. It varies among adults versus children. The numbers for Metis are around 7.3 per cent, 10 per cent for First Nations off-reserve and 17 per cent among First Nations on-reserve. When you look at comparability, there is basic comparability between non- Aboriginal Canadians and Metis, although of course the numbers are of concern because they are somewhat higher.
What is also of concern related to diabetes is being overweight and obese, which is a direct risk factor for diabetes. The committee would also be interested to know that 60 per cent of Metis aged 18 and over are considered overweight and obese compared to 51 per cent of the non-Aboriginal population. Those statistics are based on the Public Health Agency's own surveillance data related to information provided to it. I can go into more detail around how we obtain information, but those are the rates.
The Chair: Are any of these funds being spent by the government at the federal level directed to these problems that correlate with diabetes?
Ms. Israel: I will start and then Ms. Langlois can continue. One thing that is important is not only being able to address diabetes as an issue but also being able to address the collection of information related to peoples either self- reporting or reporting as Metis. This is one of the issues when it comes to overall public health surveillance in the country and it relates to our success at being able to answer questions such as yours with respect to those specific rates.
The Public Health Agency of Canada invests monies and is doing a lot of work in parallel with Metis organizations, specifically the Manitoba Metis Federation, the Métis Nation of Ontario and the Metis Provincial Council of British Columbia, to work directly with these organizations to compile accurate data on Metis so that we can continue our surveillance efforts. Apart from the collection of data sources and data information, it relates to some of our work on the Canadian Diabetes Strategy, which works closely with the First Nations and Inuit Health Branch. Community action programs are available to organizations to develop projects to either prevent diabetes or address diabetes risk factors.
Our programs are available for all populations, but I will turn to Ms. Langlois with respect to other information.
Ms. Langlois: Specifically with regard to what First Nations and Inuit Health Branch does with Aboriginal diabetes off-reserve, a small portion of funding is dedicated for Aboriginal groups off-reserve. The Metis have access to that. In my remarks, I commented on the number of those projects that Metis are able to access. Currently, they are able to access 25 specific projects across the country under the urban First Nations, Inuit and Metis stream of the Aboriginal Diabetes Initiative. Those programs are by and large health promotion and prevention. They are not about treatment aspects, which would fall under the responsibility of provincial services, but the federal government maintains a broad mandate around health promotion and disease prevention, and specifically in this area a decision has been made to fund projects accessible to Metis.
Senator Munson: You mentioned the budget of 2005, and you have a lot of figures here. There is no mention of Budget 2012. Can you bring us up to date if there is increased funding in Budget 2012 for Metis?
Ms. Langlois: The reason for mentioning Budget 2005 and Budget 2010 is because those were the years in which programs related to Aboriginal populations were renewed. Significant health promotion and disease prevention programs were created in 2005 and renewed in Budget 2010 and they continue today. The funding levels were provided for a profile of 2010 to 2015. I was referring to the funding profiles approved in Budget 2010.
Senator Munson: There is nothing in 2012 to increase this?
Ms. Langlois: There are no increases. It would be maintained at the funding profiles currently there today.
Senator Munson: I am curious how you measure success. You talked about health promotion and prevention. With this kind of funding, and you talked about provincial governments doing their work, do you have any analysis on how you would, particularly as the chair talked about in the diabetes initiative, which is very important, measure the success of, let us say, the 51 projects that were accessible over this five-year period in terms of awareness and better eating habits and so on?
Ms. Langlois: The Aboriginal Diabetes Initiative overall is subject to evaluation on a periodic basis. The program actually started in 1999. In the early years, amongst Aboriginal populations when we started the program in 1999 there was an indication that diabetes was an issue. We found in the first five years of the program, the first evaluation, that what the program did is raise awareness. In fact, diabetes rates went up because previously undiagnosed cases were now being found and people were becoming aware that they should be tested before getting to the stage that significant complications were appearing in their bodies and lives. That was the significant impact of the first five years of the strategy.
The second five-year evaluation demonstrated that once awareness was there, we started to see community mobilization around the issue. The second part of the strategy put in place prevention workers. I am speaking mostly here on-reserve where the bulk of the program funding is focused, but I think the results are pretty much translatable in an off-reserve context as well in terms of what it takes to have success.
In terms of communities mobilizing, ensuring they have healthy sources of food, people are eating healthily and being physically active, we start to see communities mobilize, and it is important to have the mobilizers.
In terms of the off-reserve program, we would expect to see the same kind of results. Again, it is about awareness and then taking action.
The programs we are funding off-reserve consist of 25 of 28 projects focused on Metis to continue to do just that — to continue to build awareness, but also to have some prevention-type programming so people can become aware of the things they need to do in their lives to address diabetes and hopefully prevent it from happening in the first place.
Senator Munson: I just have one other question for the moment. I would like to get some figures on the Metis and diabetes, percentage wise. I think you talked about that, chair.
Ms. Israel: Would you like me to repeat the figures?
Senator Munson: I would like to write them down, yes.
Ms. Israel: In terms of non-Aboriginal Canadians, the rates of diabetes are around 5 per cent. If you look at the population level — and I do not have the figures available to me — certain age groups are more at risk for diabetes. Some of the figures of the Public Health Agency of Canada show that adults of a certain age now are becoming more susceptible to diabetes, especially in Aboriginal populations. This is an emerging problem.
Among Metis, the rates compare at around 7.3 per cent as things stand right now. Some of the other figures I was talking about are cause for concern for the agency, including rates of overweight and obesity, as well as inactivity. However, the measures are not far off from the non-Aboriginal population as it relates to Metis.
The work of the Public Health Agency of Canada continues to develop and we continue to work with Metis organizations to ensure the information being reported to us is accurate and that information provided by Metis to public health providers or to medical professionals includes that they self-identify. It is important for people to self-identify as Metis so we can gain access to that information, and it is important that the information is accurate.
Senator Munson: You use the phrase "cause for concern." Is it more than that?
Ms. Israel: Maybe I should preface my words. I think diabetes writ large in Canada is cause for concern in the sense that we provide special emphasis on ensuring Canadians are aware that diabetes rates have been increasing. They have been steadying off over the last couple of years. However, the risk factors for diabetes are of concern to us — in other words, eating well, being able to be physically active, and lowering smoking rates. All of that is important with respect to disease prevention.
Senator Munson: I have questions for the second round.
Senator Raine: Thank you very much for being here. Ms. Israel, you gave us some statistics. You broke it down in different ways. It would be very useful for me personally — I do not know if you have it here but please send it to us, if you could — to also break out the Inuit population, because it is a stand-alone population as well.
I am wondering if you could also provide us more detail — you could follow up with us — on the changes or the rates. You said the rate has been increasing but is leveling off. Is that a significant impact across all those different groups, or is it leveling off in the total population but perhaps not in the Aboriginal populations?
Ms. Israel: I would have to get that information, Senator Raine. I can go back and get it.
Senator Raine: I agree for everyone that this is a big cause for concern, and it is obviously connected with lifestyle, education and many different factors. If we are to tackle this big health issue, we need to have a plan.
It takes me back to when public health started tackling smoking many years ago. The amount of money put into the anti-smoking campaign and the information campaign was significant and intense across all media. I am wondering if we are doing the same thing with regard to the problem of the precursors for eventual diabetes.
Could you comment on the difference in the money being spent on anti-smoking versus the promotion of active, healthy living?
Ms. Israel: I do not have the figures that would be able to compare the investments that have been made in the past vis-à-vis smoking cessation or tobacco vis-à-vis physical activity or eating well. However, I can talk a bit about some investments made in recent years and some of the attention that the Minister of Health has brought to bear on some of these issues.
You are quite right in saying that attention needs to be paid with respect to the precursors, the risk factors. In terms of healthy weights, federal, provincial and territorial health ministers signed on to the Declaration on Prevention and Promotion, as well as the action plan to curb childhood obesity and promote healthier weights. This was done in recent months and has led to quite a bit of activity in the health portfolio, and it has brought increased attention to these issues, including a summit that was held a couple of months ago that brought together stakeholders from the nutrition industry, governments and community organizations so that everyone could understand the problem and take steps to address it.
There are initiatives on healthy living that try to meet the physical activity targets set out by federal, provincial and territorial ministers of sport, physical activity and recreation, as well as investments made to ParticipACTION to ensure Canadians are moving and avoiding sedentary lifestyles. We know those kinds of investments are important so that we can take steps to prevent the onset of diabetes in earlier and earlier ages.
Another initiative that took place in recent months was working with Shoppers Drug Marts throughout Canada to bring attention to diabetes. The Public Health Agency of Canada partnered with them and is partnering with Pharmasave as well, through other provinces and territories, on a diabetes questionnaire that would raise attention to what those risk factors are, as well as what some of the genetic predispositions are for diabetes. That is based on scientific evidence that was done at the Public Health Agency of Canada.
While I cannot compare, I can say with confidence that a lot of increased attention has been paid to this issue in the last two years alone.
Senator Raine: My information is that the dollars being spent are in the neighbourhood of $50 million to $80 million per year on anti-smoking and $2 million to $5 million per year on health promotion.
Ms. Israel: I cannot quantify the exact amounts in total, but just with respect to some of the investments that have been made, the figures exceed that $5 million amount.
Senator Raine: I am sure my statistics are out of date. I can see that what we have done on the smoking cessation program has worked, and that is very good.
I guess the challenge we all face is how we relate these statistics to any specific issues and problems facing the Metis people. I am hearing from you that those figures are very hard to get because of the self-identification and the fact that it is provincial and federal in terms of health delivery.
Ms. Langlois: I would add that the bulk of the responsibility here would be at the provincial level, not at the federal level, in terms of serving Metis in the health system.
Senator Lovelace Nicholas: Thank you for being here. You mentioned that there is an increase in diabetes. In your study, did you look at the ratio of people with diabetes — the people in a working group and people who are on social assistance? Was there a ratio in the study of who was more at risk for diabetes?
Ms. Langlois: I am trying to recall. The closest thing I think we have would have been in a nutrition survey where we looked at nutrition and health for Aboriginal people living in urban environments off-reserve. I think we would have found that they were food-insecure. I am not sure if we did the link to income, so we would have to go back and look to see if we can find it. We would expect that First Nations and Inuit and Metis who live off-reserve would potentially fall into the lower-income brackets, and maybe there is a link there. However, definitely off-reserve Aboriginal people are more food-insecure. That food insecurity is a major risk factor for many health conditions, but if you are not able to access healthy food, obviously you are at risk of diabetes. I think we could go back and look to see if we have any data there.
Senator Lovelace Nicholas: The reason I asked is that people who are working can afford to buy healthy food, like you said. However, people on social assistance have to buy what is out there that they can afford, which is mostly pastas and food that will fill their children faster. They are not healthy foods. Thank you very much.
The Chair: I will now go back to Senator Munson.
Senator Munson: I wanted to talk about Aboriginal Head Start and get a few more details about the program.
Again, how do you measure success with these kinds of programs? We hear so much about them, but we do not have any specific examples of success or non-success with these particular programs. Perhaps you can give a picture of what Aboriginal Head Start is for people who do not know.
Ms. Israel: Sure. That is a great question. I will start because Aboriginal Head Start exists not only for on-reserve communities but also for urban and northern communities. The distinction between the Public Health Agency of Canada and Health Canada is that we are mandated to deliver Aboriginal Head Start in urban and northern communities. This program provides $32.1 million in funding to Aboriginal communities to deliver early childhood development programs for Aboriginal children aged three to six.
[Translation]
The name in French is "Programme d'aide préscolaire aux Autochtones."
[English]
I use the French description because it says "preschool." In other words, the emphasis of Aboriginal Head Start is exactly that, to get a good head start in life by respecting culture and the need to ensure good preparation and good prevention, not only of disease but referring to all the factors that will lead to a good start in life.
For the Public Health Agency, there are 128 Aboriginal Head Start urban northern community projects. We reach about 4,800 people. Of those 4,800 kids and families, about 19 per cent serve the Metis communities. Those people have self-identified.
Of the 128 projects — of course, all of the projects would serve a contingent of Metis children and their parents — specifically we try to ensure that we cover in high-population areas of Metis where we can deliver Aboriginal Head Start programs. There are five specific Aboriginal Head Start programs for Metis organizations that serve children and their families that total $1.6 million. As I said before, so I am clear and there is emphasis, there are six core components of the program. We look at education, health promotion, nutrition, culture and language, parental involvement, and social support. There are those five projects — one with Fishing Lake, one with St. Laurent Recreation Centre, Annie Johnstone, Awasis, Peavine Metis and another in Alberta.
Senator Munson: We have heard of these programs because of the federal responsibility. Is there anything dealing with autism within the Metis or Inuit community? A lot of us are working in that field and we understand, for example, that Health Canada just established a new surveillance. It is just the beginning; it is at an embryo stage. It will be good to understand, but I do not know if we have statistics in understanding the prevalence and rates of autism, other neurological disorders, developmentally delayed or whatever term you want to use, within the Metis and Inuit communities, and I think it would be important to know that.
Ms. Israel: I will definitely note that, Senator Munson. Your points are well taken, and it speaks to some of the work under way in the Public Health Agency to really define the issue. In society at large I think there is an understanding of the challenges faced by autistic children and their parents but not as much understanding in how to ensure that, from a surveillance perspective, we capture the rates so that we understand better the nature of the issue.
As you said, we are almost in our first steps. Through that work and through that compilation, it is almost like an A plus B equals C. We get the information, then we know what to do with it; we improve policy and we deliver programs. Like you say, we are working with researchers and others to ensure that we understand this issue better.
Senator Munson: I think it would be good to understand if within the Inuit community the rates are lower or higher. We have talked about the environment that we live in. We talk about the DNA, the parents in southern communities, in the United States and in Canada. I think it would be important to have a better understanding in Canada's North whether, for example, the percentage is lower. The argument could then come into play in terms of dealing with the environment, the air we breathe and how we live. Thank you.
Senator Patterson: Thank you for being here. I will take a different angle than my colleagues so far. One of the things we are focusing on in our study of Metis in this committee is the definition of "Metis." You described a huge array of programs in your opening remarks, Ms. Langlois: diabetes, youth suicide prevention, Head Start, human resource initiative and the transition fund. Under the First Nations and Inuit Health Branch, on the face that title does not include Metis. However, you explained that based on policy a number of those programs are accessible to Metis.
Do the policies that were developed to make these programs accessible to Metis provide a definition of who is a Metis?
Ms. Langlois: They tend to come from the point of view that we would work with the Metis representative organizations or their affiliates and the involvement of the role out of programs. For example, under the Aboriginal Diabetes Initiative, when an RFP goes out for the off-reserve programs, we ensure that the Metis affiliates are aware and are able to compete in the RFP — at least that they are aware — and there is follow-up to see if they will be involved in the RFP processes. We do not tend to go strictly on any kind of population numbers or definitions. It is more of a policy that this is available to Metis and then it is how do you access where those groups work.
Senator Patterson: We see in the definition of "further programs," the Aboriginal Diabetes Initiative and the prevention stream that the programs have been described as Metis, off-reserve Aboriginal and urban Inuit prevention and promotion program. You have outlined how the Metis have become significantly eligible for programs under those initiatives, again by partnership, as you described it, with the Métis National Council, I believe you said.
Do I take it, then, that with this challenging question of defining Metis — and I think we will be grappling with it in our study — the policy of the Public Health Agency of Canada and Health Canada has been to let the Metis organizations deal with that issue and define their membership? Is that correct?
Ms. Langlois: I think that is correct. That would be an accurate way of describing it.
Ms. Israel: I would agree. As Ms. Langlois said, we will go out with a request for a proposal on a specific solicitation for a program. We, of course, work closely with organizations and partner with those organizations on our programs. There is a long-standing history there between Health Canada and, more recently, the Public Health Agency of Canada that has cemented the way we do and conduct our programs. This relates to that identification.
Ms. Langlois: If I could add, under the Aboriginal Diabetes Initiative we are working closely with our PHAC colleagues who run the Canadian Diabetes Strategy to ensure that our programs are complementary to each other. That is an important priority for us, moving forward.
Senator Patterson: With regard to your scholarship programs that target Metis students — and I am not being critical in any way; this all sounds good — you are not concerned about defining who Metis are for the purpose of these scholarships? You are leaving that to the Métis National Council?
Ms. Langlois: I would say in the 2005 to 2010 period the Métis National Council was the holder of the funds for Metis scholarships, but that has shifted to the National Aboriginal Achievement Foundation, which runs many educational programs for Aboriginal people more generally.
The program now provides $10 million to the National Aboriginal Achievement Foundation, recently named Indspire. Over the five-year period they will be getting $10 million from Budget 2010 to 2015, as opposed to the previous $8 million just for Metis.
Senator Brazeau: Good morning to both of you. I will try to dig a bit deeper. Obviously with this study we will be examining the whole issue of self-identification of Metis.
Having said that, the Métis National Council, for example, is basically a political Aboriginal organization. They base their citizenship on membership.
You mentioned that many Metis people have access to the programs that you have outlined in your presentation. Given the fact that an organization, for example, will have a membership, what does FNIHB do to ensure that those who are not members of those organizations have access to those programs?
I see the case in point that many departments — and I have a lot of experience in this — do not want to delve into that issue of who the Metis are and leave that to the organizations. I also see a responsibility of the federal government to ensure that Metis people who may not be members of these organizations also have access to these programs. What do you do to ensure that?
Ms. Langlois: The example I would give again is under the ADI off-reserve urban program. When that RFP goes out, it goes out to all Aboriginal organizations that work off-reserve. Friendship centres have tended to have a number of projects across the country. Again, we are not going after sort of who is a member or who is not a member; it is the organizations themselves that work in the health field that are targeted for these RFPs.
Friendship centres definitely make services available to anyone. Those are the kinds of organizations. We are not focused on who is or is not a member. It is more generally making the funding available to organizations that work in the field.
Senator Brazeau: In terms of the contribution agreements that you sign with different organizations, how do you ensure that Metis people have access to these programs, regardless of whether or not they are a member?
Ms. Langlois: I guess it would not be a very detailed audit of any kind. It would be ensuring that we would get the reports from the organizations about what services they have delivered. I think we would have some interactions. We have program officers who interact with the organizations, and there would be opportunities to bring them together into networking meetings where, for example, the 28 projects that we are currently funding could come together and share best practices with each other. It is through that interaction and working with the organizations that we would ensure that we would know and learn about how they offer their services. It is not in a detailed audit membership kind of way, which is what I think you are asking.
Senator Brazeau: Thank you for that. That is a good segue to my next question, which is along the lines of that of Senator Munson with respect to outcomes and deliverables.
In your presentation you mentioned a lot of funding that is being spent for Metis health programs. You mentioned a lot of different programs that are available, which I am familiar with. I was involved in many of those previously as well.
Reading your presentation, it sounds like these programs are serving a purpose. People are taking advantage of them and they are successful programs. If these programs are successful and changing the lives of some people, how would one explain an unconfirmed fact? Reports are out there whereby funding reductions have been made to Aboriginal organizations. For example, 40 per cent with the ITK and the AFN, and 100 per cent of NWAC's, and the MNC's health budget has been reduced.
If these programs are successful, and if there are positive outcomes and the reporting requirements are coming in and the department accepts them and clear targets are being achieved, then why the cutbacks?
Ms. Langlois: Unfortunately cutbacks are a reality of any kind of budget prioritization process where you have reduced funds to work with. In this environment the decision was made that we would protect the front-line service delivery in First Nations and Inuit communities, which is the major mandate of the First Nations and Inuit Health Branch.
In this environment we chose, for organizations that we are kind of calling non-service-delivery organizations, in the sense that the national Aboriginal organizations do not deliver front-line services as the communities do, that those were a lower priority in the exercise. As a result, they were subject to cutbacks. It is about prioritizing and ensuring that we protected the money in the communities, which is what we have done.
Senator Brazeau: Let me be very blunt. I understand in this day and age that cutbacks are needed. However, if these programs are actually making a difference in people's lives and they are successful and organizations are reporting what they are supposed to report, why the 100 per cent cutbacks to the MNC? We are dealing with Metis this morning so I will keep my focus on the Metis. Why the 100 per cent cutback in funding? To be blunt, were there any reporting or auditing issues that came out of funding that went from Health Canada to these organizations? What is the answer here?
Ms. Langlois: I think the answer is that the Métis National Council does not deliver front-line services. That is the answer.
Senator Brazeau: I beg your pardon?
Ms. Langlois: The Métis National Council does not deliver front-line services, so service delivery. The organizations funded under the Aboriginal Diabetes Initiative are affiliates of the MNC, but the MNC itself does not deliver services.
Senator Brazeau: Were there any reporting or auditing issues with any of the MNC affiliates?
Ms. Langlois: No, not that I am aware.
Senator Brazeau: Thank you.
Senator Ataullahjan: I apologize for being a bit late. I am looking through your presentation. I notice that you talk about the Maternal and Child Health program. As you are aware, maternal and child health programs are the MDGs that are being met by United Nations 4 and 5, and these are the two that are lagging. What kind of numbers are we looking at? Can you tell me a bit about the Maternal and Child Health program?
Ms. Langlois: The reason it was listed here is I was providing an outline of funding provided in Budget 2005 or the $700 million announced there. That program, however, is exclusively delivered on-reserve. There are no services to Metis in the Maternal and Child Health program.
Ms. Israel: However, there are programs that are delivered by the Public Health Agency which Metis will benefit from and have benefited from. I will list two in particular. I talked a bit about Aboriginal Head Start, but there are two programs that are close to the Maternal and Child Health programs of FNIHB. One is the Community Action Program for Children, which provides $53 million a year to community-based groups for vulnerable children and their families who experience poverty, teen pregnancy and social isolation. As part of that program, emphasis is placed on serving Aboriginal children and their families. There are 65,000 participants in this initiative and 4 per cent self-identify as Metis. I would highlight that, as well as the fact that as part of those 440 projects, five are specifically directed to Metis organizations in order to serve Metis children and their parents. The other program is the Canada Prenatal Nutrition Program, which looks at working with vulnerable mothers, ensuring they have information to get a good start for their babies. That is open to Metis organizations as well.
Senator Raine: On the nutrition program that is delivered at various levels through the Public Health Agency of Canada, are you tracking the results? Are people becoming more aware of the dangers of children drinking soft drinks, high sugar-added cereals and high salt content of the things that we know are bad for you? The program that you are delivering, specifically in Head Start and the Canada Prenatal Nutrition Program, are you focusing in on the dangers of pop and salt?
Ms. Israel: I would say yes, that is for sure an emphasis placed in the Community Action Program for Children. I will talk about both because for the Canada Prenatal Nutrition Program, nutrition in its title, we place a lot of emphasis on ensuring that mothers understand the importance of eating well themselves and once their babies are born, the importance of breastfeeding, how you feed your child and the importance of feeding your child well. Specifically with respect to soft drinks I would have to go back and confirm that, although I can say that for programs that serve children aged zero to six, emphasis is placed on food skills and the importance of good eating practices and physical activity. As you know, even in those young ages and stages, setting the tone for healthy eating and good physical activity will ensure that you get a great start in life. For sure, the emphasis is placed on nutrition.
Senator Raine: We hear that families who are living in poverty and in tough situations cannot afford good food. Yet, highly processed food is more expensive and it is less nutritious. However, if your skills for cooking your own food are missing, then you are off to a bad start instead of a head start. I commend you for the work that you are doing in that area because it is very important.
The Chair: Thank you colleagues, and I would like to thank Ms. Langlois and Ms. Israel for coming so well prepared, and they were candid and straightforward in their responses. We thank you for that and for your presentation as well.
Is there any other business?
Senator Munson: I am curious as to when we will be inviting Metis leaders because what Senator Brazeau was talking about is extremely important with some of these cuts we have seen. You have good work here and then cuts on another side. You have to seek out just how bad these cuts are and how it affects programs like this, also taking a look at the inside of the Metis nation, so to speak.
The Chair: We are in the process of inviting these groups. If the committee wishes, we can circulate the future agenda to each office as to when these particular organizations will be appearing before us.
Senator Munson: Thank you.
The Chair: Also, Senator White has joined us this morning. Thank you for being here.
Senator White: Thank you.
The Chair: With that, the meeting is adjourned until tomorrow night.
(The committee adjourned.)