Top News - May - 2003 Published May 12, 2003 Deadline looms for signing health consent form Suicide prevention Hard work pays off for grads This is only a partial listing of the stories featured in the May 2003 issue of Alberta Sweetgrass. If you are not receiving your own copy of Sweetgrass, then you have missed out on a lot. Deadline looms for signing health consent form Paul Barnsley, Sweetgrass Writer, Ottawa First Nations people who access Health Canada's Non-Insured Health Branch (NIHB) services must sign consent forms so that their private information can be used by the government. The deadline for signing is Sept. 1, and if people don't meet that deadline they will be forced to pay cash, up-front, for medical services. NIHB pays for medical care given to status Indian clients if care isn't covered by other programs. Elaine Johnson, the Assembly of First Nations' health director, said the government's form is a blanket consent form that she's afraid could allow the government to collect data that might be used to undermine Native entitlements. Leslie MacLean, the director general of the NIHB, said that's just not the way it is. "There are professional ethics on how you do research. One of the things that's clear about how you do research is that you don't do research on people without having their permission," MacLean said. "So one of the things that we're looking at clarifying right now with First Nations and Inuit people is just that. This data is not being collected for research purposes. This data is being collected to help us pay the bills, to help us examine how benefit areas are being used to make sure we're predicting trends accurately, and to share information on a very limited basis with health-care professionals to help protect people's safety." She emphasized that any decision to collect information on First Nations clients above and beyond those uses would require another, more specific consent form. Johnson said First Nations people have heard those kinds of assurances before. "People are mistrustful of what this information is being collected for, and I think that's the bottom line. Health Canada has not been able to articulate, once they get this information, what are they going to do with it. Who has access to it? Who are they going to share that information with? Are there First Nations that are involved in that process so they can monitor to make sure Health Canada's accountable for what they say they're going to do?" she asked. "They say, 'Oh well, you're protected by legislation.' But you and I know what legislation can and cannot do." Johnson said some Native people see signs of a hidden agenda. "That's what a lot of people are suspecting. That there's something else, a hidden agenda, here. But [the government officials] say that there's not. They say that their ultimate goal is to protect the client. But they need to be more up-front. I'm a nurse and I've said this to them as well. I said, 'You've come up with this deadline of Sept. 1. My bottom line as a nurse is there are people who have very grave concerns about this consent. Come Sept. 1, they are not going to sign this consent. And then what are you going to do? You're going to have people who are not going to have the service and then you're going to have big problems. Because it's a bread and butter issue. It's life and death issues we're talking about." Johnson said Health Canada is quoted in information that the reason they're pushing the consent form is because of the Personal Information Protection and Electronic Documents Act legislation, which has to do with privacy protection for electronic records. Another reason the form has been developed, it's been said, is because some Native people were using the current system to access prescription drugs to overdose, or to feed their addictions. The auditor general and the public accounts committee have both pressured Health Canada to do something about First Nations' abuse of prescription drugs. MacLean said her agency is just playing catch-up, that modern technology requires new legislation to protect the public from having private information used for illicit purposes-inside or outside government. "There's three pieces of legislation that were all coming together to tell us first, that we needed to get explicit consent from clients in order to keep paying their bills, in order to respect their privacy rights and in order to protect their safety. Because, unlike many other federal or provincial programs, we [the NIHB] don't have a legislative base. So if I take a federal example like Veterans Affairs . . . when people apply for benefits under Veterans Affairs, they have to sign a consent form. The form says, 'I'm applying for these benefits and you have a right to see if I'm eligible and you have the right to keep the information on file,'" Leslie MacLean said. "We require client consent in order to meet federal, provincial and territorial privacy requirements." But First Nations people who won't sign the form out of fear that doing so might affect their treaty or Aboriginal rights are going to be forced to pay for the services up front. "As you can appreciate, without the information we cannot pay the bills," said McLean. "If I don't know that a client has gone in, gotten his teeth cleaned, paid and that the service was $95 and it was received on Oct. 11 for the person who has this treaty or status number, we have no authority to pay the bill." Elaine Johnson said that approach is not going to work. "What is Health Canada's liability? Come Sept. 1 when individuals have to sign a consent form, if an individual says, 'No, I will not sign,' the client can do what they call a one-time reimbursement form. What that means is they can do a one-time consent, they can pay for the medication. But that's only if they have the money to do so. If they don't have the money, they don't get the product. The concern I have is, if somebody still refuses to sign, then what's the liability of Health Canada if something happens to an individual who refuses to sign consent? A lot of people who access non-insured health benefits, a lot of them are diabetic, have arthritis, chest pains. They really require the medication. If they decide that this is not good for them, then their health is jeopardized." NIHB coverage has been cut repeatedly over the last couple of years. First Nations leaders worry this is another tactic to reduce expenditures. "My concern with non-insured is that Health Canada tends to look at it from a fiscal view. We in First Nations look at non-insured as a service issue, " Johnson said. Native physicians say the level of care under NIHB has dropped alarmingly in the last few years as a result of government cutbacks. Johnson sees the same thing. "Exactly. Based on fiscal reality. It's not based on what services should be provided. And that's the concern that we have. They make benefit cuts, but it's not based on service, not on what services should be provided." MacLean said the information collected by Health Canada from those who do sign the form will help the government improve its level of service. "Pharmacists are paid to catch drugs that contradict one another at the local level. But they don't always catch it. So there's all kinds of follow-up activity that private and public plans do," she said. "It's normal for benefit programs to have consent and it's normal that there be monitoring to make sure that people are getting benefits appropriately." Top

Suicide prevention Yvonne Irene Gladue, Sweetgrass Writer, Hobbema Carrying signs, an eagle staff, and a talking stick, a group of people who began a walk to Ottawa in Nanaimo, B.C. on April 1 arrived in Hobbema on April 24. The 10 people taking part in the Youth Suicide Prevention walk are hoping to create awareness on the topic of suicide in Aboriginal communities across Canada. They met with chief and council at the Ermineskin band office where each member of the group stood up and disclosed how suicide has affected their lives. Chief George Mine of the Ermineskin thanked the walkers and said that they were doing a selfless duty to bring this topic to the rest of Canada. After the meeting, the group walked over to the Samson First Nation where more than 50 people gathered at the cultural centre to hear the group's testimony. A drum group from the community performed honor songs, and a luncheon was provided. "The idea is to raise awareness all across Canada and at the same time we want some advice from Aboriginal communities along the way. We don't know much about what we are doing, but we might get some ideas and encouragement along the way," said walker Paul Laliberte. "We are in a crisis in Canada with our Aboriginal youth, and financial help is needed to address this issue." Laliberte said he and the group would like to see a centre built in Nanaimo that would house various health programs for Aboriginal and non-Aboriginal people on the prevention of suicide. He would also like to see money poured into programs dealing with suicide in Aboriginal communities, and monies to help pay for the cost of a help line in Aboriginal communities, and counselors to be available 24-hours-a-day, seven days a week. The group is planning to arrive in Ottawa to present their ideas about suicide prevention on June 21, National Aboriginal Day. Rick Lightning, the crisis intervention worker at the family wellness centre with Hobbema Health Services, said the group is doing a good thing trying to raise awareness about suicide. "It is a heavy burden that they are carrying. They are doing what a lot of people are not doing and it takes a lot of courage and faith to do that. I wish them success because their success is if they get their message across to the prime minister then their success will be everyone's success." Rick Lightning believes that one reason for the high number of suicides in Aboriginal communities is that it is often romanticized. He's heard kids say that they think that they are going to have this wonderful funeral and people are going to stand by their coffins and cry. He said that he tells the young people that they are not going to a wedding when they die from suicide, that what they are doing is final. "Death is final. There is no turning back when you do it. It is not like you wake up the next morning, and say 'Oh, I made a mistake and I change my mind." Lightning said that he wishes young people would realize that they are not the only ones who go through self-doubt and think they are not perfect. He said that everyone, at one time or another, realizes that they are not perfect and everyone has made mistakes. "Sure, it might be hard while someone is going through problems or feelings of doubt. Every one of us living in this world goes through that. Look at all the other people. I bet if you asked them if they were perfect they would tell you they were not. They would tell you they wish they had a different nose, better clothes, a better car, a better job, better relatives, better parents, that they were skinnier or fatter, taller, shorter, or whatever, and youth have to realize that they are not the only ones in the world who go through self-doubt," he said. Top Hard work pays off for grads Yvonne Irene Gladue, Sweetgrass Writer, Edmonton On April 25, more than 100 people gathered at the Canadian Native Friendship Centre in Edmonton to honor 25 graduates of Grant MacEwan's Mental Health Diploma Program (Aboriginal Connections 2003). The graduation ceremony included a feast, cultural entertainment, a rites of passage ceremony and speeches. Ruth Suvee is chair of the two-year diploma program. She said she was proud to see the students at the ceremony, because she felt that they deserved to be recognized after all the work they did to achieve academically and in their personal development. Ruth Suvee, who is originally from the Kikino Métis Settlement in northern Alberta, has worked in the health and education field for more than 30 years. "I like watching the students when they complete the course. I see all the work they've done on themselves and it makes me proud to see them graduate. The only challenge I saw for the students is that a lot of our students are single parents, so they've had to balance their school life, their personal life and family life, so we try to give them as much support as we can, to make it through the course," she said. Top