Sioux Lookout residential school survivor shares fears regarding new legislation

Tim Brody - Editor

Sioux Lookout’s Garnet Angeconeb, a survivor of Pelican Lake Indian Residential School, said he is fearful that a legislative change may see him sent away from the community.
Bill 7, More Beds, Better Care Act, 2022, (https://www.ola.org/en/legislative-business/bills/parliament-43/session-1/bill-7) received Royal Assent on August 31. 
An explanatory note about the Bill on the Legislative Assembly of Ontario’s website explains that, “The Bill amends the Fixing Long-Term Care Act, 2021 to add a new provision for patients who occupy a bed in a public hospital and are designated by an attending clinician as requiring an alternate level of care. This new provision authorizes certain actions to be carried out without the consent of these patients. The actions include having a placement co-ordinator determine the patient’s eligibility for a long-term care home, select a home and authorize their admission to the home.”
The note goes on to state that, “Certain limitations apply. The actions cannot be performed without first making reasonable efforts to obtain the patient’s consent.”
Angeconeb, a Lac Seul band member, now resides at the Sioux Lookout Meno Ya Win Health Centre (SLMHC) where he is an Alternative Level of Care (ALC) patient. Angeconeb lives with the neuromuscular disorder Kennedy’s disease, and as a result, requires 24-7 assistance.
“The situation in northern Ontario and northwestern Ontario is completely different than Toronto or Ottawa or any place down there. What goes on down there, Bill 7 might be workable. But up here, our situation is quite unique. It’s different, and I think there needs to be some accommodation made for the north. When I think of Sioux Lookout, I think of we only have a 20-bed extended care facility here. That’s not a lot. Therefore, the demand is a lot higher than the supply. There’s a long waiting list. I was on the waiting list for 10 years. I did make it, but at the time… this is a couple years ago now, I wasn’t ready to go then. I am now. So, I’m back on the waiting list. I don’t know how long I’m going to be on the waiting list again. So, when you think of a 20 bed facility in Sioux Lookout, it just doesn’t serve this community, it serves the region and that’s really the problem, really, is limited space, and so we have a lot of people here in the hospital that are I guess what the government calls alternative level of care patients, such as myself, people waiting to get into extended care. So, here we are. We are called ‘bed blockers’. I’ve never blocked a bed in my life,” Angeconeb shared.
He continued, “We have people here, local residents, and we have people from the catchment area of the Meno Ya Win. So now, Bill 7 is meant to create more beds for the hospital. This is where it gets really frightening, for me anyway, but also for some of the people I know that are occupying beds here who are not from Sioux Lookout, they’re from other communities. Where are they going to go? They’ve already left their communities. Sioux Lookout is not their hometown. So, we have a number of people who aren’t from Sioux Lookout. They’re from up north. They are already disadvantaged by the fact that they are already away from home. So, with this legislation they could potentially be forced to go somewhere else even further away. And so, I think again, if it was southern Ontario, if you were in Toronto or Guelph or Barrie, those places aren’t that far away down there. But if you’re from a fly in community up north, you have that added stress, so that legislation really does not make sense in that regard.” 
Angeconeb commented, “In my own situation however, I fear the effects of being institutionalized. Yes, I know that I need services. I need help, there’s no question about that and I appreciate the help I’m getting here at the hospital while I’m on the waiting list for Extended Care. However, there’s fear here that I could be sent away to a location that’s not my choice, and so as far as I understand the way the legislation is going to go, that’s a real threat where I could be taken away from my family, my children, my partner, my kids and grandchildren, and my community. That’s through government legislation that I don’t have any control over. And so, it’s so similar to residential school, that we were taken away as children from our families and our communities by government legislation, government rules and policies and here we are again, at least in my case, I’m going through a process of institutionalization. Institutionalized as a child. Institutionalized in the sunset years of my life. I want to know, I don’t want government legislation to separate me and my loved ones. I’ve already been through that already and I don’t need to go through that again. What I’m saying then is I think we need to look at alternatives.”
For example, he said, if enhanced services were available at Sioux Towers, where he formerly resided, he would be able to continue residing there.
“So, I think that’s something that needs to be explored for sure. But also looking at some of the other needs people have here, whether you live at Cole Terrace, or whether you live at Patricia Plaza. There’s certainly, I think, better ways we could improve the level and the quality of services we’re currently getting so we do not occupy beds here at the hospital,” he stated, adding, “What we need are improved services all around. I get really discouraged by the various political parties, who have come here and have announced a 76-bed addition (to the William A. George Extended Care Unit’s current 20 beds). Where are they? That’s been discussed since 2018. When is a convenient time to talk about it? When they’re out campaigning to get our votes, so we vote for them, and they don’t deliver. Here we are, we don’t have the 76 beds that were promised both by the Liberal Government and the last time the Conservative Party when they were campaigning in 2018. There’s nothing here. A lot of people in town are disillusioned with the fact that nothing has moved in that regard, not even a speck of soil has been turned over yet… so we need to get moving, that’s another answer to our situation.”
“I cannot say enough about the good things that I’m provided with (at SLMHC), but the system certainly can be improved so that people like me can still enjoy life at home with my loved ones and my kids and grandchildren,” he said.
Angeconeb sent a letter expressing his concerns to Premier Doug Ford, Deputy Premier and Minister of Health Sylvia Jones and Minister of Long-Term Care Paul Calandra.
“I don’t really expect the government to reverse its decision or reverse Bill 7, however they need to come to what I will call a table of common understanding so these kinds of situations can be addressed in a good way without having to move people great distances away from their communities. In this case I believe the government can and should make some allowances and take into consideration the unique needs of our region and Bill 7, the way it is, doesn’t do that,” Angeconeb said. “There has to be a willingness of everyone to come together. The provincial leaders, the First Nations leaders, municipal leaders, I call upon the leaders to do something proactive to address this situation.”
Sioux Lookout Mayor Doug Lawrance has been exhaustively lobbying over the years to get the promised additional long-term care beds. He said people having to leave the community to find long-term care is nothing new due to the shortage of long-term care beds in town.
He recently met with Calandra at the Association of Municipalities of Ontario Annual General Meeting and Conference in mid-August.
Again, Lawrance said, there was good discussion, but as of yet, no results.
“It’s frustrating. The issue that’s before Ontario now, that has people alarmed about the bill that’s come in, moving people… it’s a situation we’ve been having for years here because of the shortage of beds in Sioux Lookout. 
“It’s not new. The inaction spans many governments and much bureaucracy. To me, it’s the political will to spend the money. It costs more to do things in the north, yes it does. But as we can see it deeply impacts people’s lives and the people in the north deserve the same as what the people in the south have. The south is up in arms about being put in the state that we’ve been in for decades,” Lawrance said.
Lawrance added, with only 20 long-term care beds in the community serving people from Sioux Lookout and across the north, “The people in Sioux Lookout are being grossly underserved right now.” Commenting on Angeconeb’s idea of a table of common understanding, “That table of common interest must acknowledge that it includes the people living in the Municipality of Sioux Lookout.”
Lawrance stated, “I don’t think it does any good whatsoever when we talk about the alternative level of care people taking up hospital beds. The patients in those beds aren’t there because they want to be there. They’re there because of a lack of homecare. Many of them could have been home for much longer and thrived much better at home if there was sufficient homecare and homecare supports, and at some stage, many of those people need long-term care and there’s not adequate long-term care.”
He went on to state, “All of this is so predictable, the population and the demographic of people growing older… for years it hasn’t been addressed and here we are in a considerable crisis. It needs to be addressed and it’s going to take a significant investment in many sectors, many parts of the healthcare and homecare systems. It’s not going to be figured out by accusing people of lounging in hospital beds as alternative level of care patients because they don’t want to go on to somewhere else.”
“It’s how we want to take care of each other,” he said of the situation, “and apparently not very well.”
Kiiwetinoong MPP Sol Mamakwa commented on Angeconeb’s situation, “I think he sheds a light on the issues elders in far northern Ontario First Nations face. There’s no programs, there’s not homecare. For example, if you sent someone from Kitchenuhmaykoosib Inninuwug to Thunder Bay, that is 600 kilometres away. That keeps on happening. When you have ALC patients in Sioux Lookout Meno Ya Win hospital, that means the system of long-term care is not working. There’s just not enough beds. That’s why there’s such a high percentage of ALC patients in Sioux Lookout Meno Ya Win hospital, or you go to Thunder Bay, you go to go Kenora, you go to Dryden, you go to Fort Frances, or wherever the closest beds are. It’s been happening for years.” 
Mamakwa added, “I think Garnet brings a good point. It’s a cycle of institutionalization that as an Indigenous patient, as an Indigenous person, and I think that’s not right. I think it’s very important for him to say that.”
Mamakwa stated, “What he’s going through is a marker of a bigger issue. That bigger issue is that Bill 7 will not work for the seniors, the elders in the north. The people that use the long-term care system, not only in northern Ontario, but all of Ontario. But also, it’s a marker of an issue that we need long-term care beds… I think northern Ontario has been forgotten. When we talk about bringing services closer to home, I think that’s one of the things that we need to be able to look at.”
He further commented, “I know they keep promising we’ll get the additional 76 beds whereby we’ll have 96 beds, but I know the last time I asked that question, probably a few months ago, the response was, yes, we’ve allocated it. Allocation does not mean it is being funded. They’ve allocated but they’ve haven’t put any resources towards it.”
Dean Osmond is the Executive Vice President & Chief Operating Officer, Chief Nursing Executive, at Sioux Lookout Meno Ya Win Health Centre.
He said the average wait for a long-term care (LTC) bed at the William “Bill” George facility is approximately 6-7 years. He said ALC patients who are designated in crisis that are hospitalized, the average wait is 3-4 years. 
Asked about Angeconeb’s fear of potentially being sent away for care without his consent under the controversial Bill 7, Osmond said, “SLMHC will not exercise this Bill. We will not transfer our patients to another facility against their will. SLMHC was created to serve the population of our region. SLMHC provides culturally appropriate care, including interpreter services, traditional foods and medicine programs. We are the hub for the communities we serve, moving our ALC’s to other facilities outside of Sioux Lookout, would remove them from these services and loved ones.”
He said SLMHC continues to advocate for the LTC beds that were allocated. SLMHC was designed to have the expanded long-term unit built onto the health centre.  “We continue to converse with the Ministry, waiting for approval to move forward. We have completed our functional plan, so we are ready to hit the ground running if the approval comes forth. Our ALC’s are now taking up more than 50% of our beds. The need for LTC beds continues to be of great importance,” he said.
He agreed with Angeconeb stating, “There certainly needs to be more services in our region right across the healthcare spectrum.”
Angeconeb said a table of common understanding could be likened to the Sioux Lookout Four Party Hospital Services Agreement, which brought representatives from Nishnawbe-Aski Nation, the Municipality of Sioux Lookout, Ontario, and Canada together to work towards a common goal, the creation of the Sioux Lookout Meno Ya Win Health Centre.
“Having a table such as the Four Party (Agreement) would bring the necessary stakeholders together. The shortage of health, human resources that the province is experiencing has certainly hit home here at SLMHC. The need for more physicians, nurses, allied health, and support staff is at the forefront. Funding is only one aspect, as the shortage of those disciplines are making it difficult to recruit, especially in the North. We need to ensure we are encouraging our youth to look at these careers when they are thinking about what they want to take in school. We need to provide incentives that make coming to rural and remote communities more attractive,” Osmond concluded.