Question Period Note: Health and Human Resources - Nursing

The Government of Canada is committed to supporting access
to quality primary health care services in First Nations
communities.
• Indigenous Services Canada works closely with First Nations
organizations, health professionals and provincial health service
providers to strengthen access to quality care, improve nursing
recruitment, and improve the integration of health services.
• The First Nations and Inuit Health Branch established in 2021 a
Nursing Health and Human Resource Framework. The
framework is designed to respond to nursing shortages and
address the potential for nursing station closures in remote and
isolated First Nations communities.

Indigenous Services Canada supports health care services in 79 remote and isolated First
Nations communities, and two hospitals in Manitoba. Of these communities, Indigenous
Services Canada directly delivers primary health care services in 50 remote and isolated
communities involving four regions (Alberta (4), Manitoba (21), Ontario (24) and Quebec (1)).
The agreement between the Government of Canada and the Professional Institute of the Public
Service of Canada will take effect starting September 1, 2022, and continue through to March
31, 2025, or when a new collective agreement is reached—whichever comes first. The
agreement includes both full- and part-time ISC nurses delivering critical services in remote and
isolated First Nations communities, and includes:
- triple the initial recruitment allowance, from $2,250 to $6,750
- triple the allowance provided after twelve months of employment, from $3,250 to $9,750
- triple the annual retention allowance, from $5,500 to $16,500
Clinical and client care is delivered by a collaborative health care team, predominantly nurseled,
including assessment, diagnostic and curative services for urgent and non-urgent care. Key
services supporting program delivery include: triage, emergency resuscitation and stabilization,
emergency ambulatory care, and out-patient non-urgent services, including public health;
coordinated and integrated care and referral to appropriate provincial secondary and tertiary
levels of care outside the community; and, in some communities, physician visits; ambulatory,
and emergency services and hospital in-patient. The program objective is to provide clinical and
client care services to First Nations individuals, families, and communities.
In remote and isolated First Nations communities, nurses (including nurse practitioners) are
often the community members’ first point of contact with the health system and provide public
health and primary care services. Nursing stations in these communities provide 24/7 access to
clinical and client care and are generally staffed by teams of nurses. Services include routine
health care (e.g. immunization, chronic illness management) and more complex emergency
medical care (e.g. heart attacks, strokes, traumas). First Nations clients also have access to
comprehensive public health services (health protection, health promotion, disease prevention,
surveillance), often delivered by nurse-led teams.
Nursing retention efforts:
Under the department’s Transformation strategy and separately the branch’s Health and Human
Resource strategy, a Nurse Recruitment and Retention Strategy has been implemented
consisting of a number of key initiatives to improve the recruitment and retention of nurses,
including educational and professional support measures for nurses practicing in remote and
isolated First Nations communities. These efforts are also designed to respond to nursing
shortages.
In August 2022, the Government of Canada and the Professional Institute of the Public Service
of Canada reached an agreement to increase the existing recruitment and retention allowances
for ISC nurses working in remote and isolated locations.
The department continues to implement an interdisciplinary model of care, having introduced
paramedics through contracted workforce sources in 2020, and is continuing to work with
professional associations and regulators to allow for the continuity of high quality care services
in communities.
ISC is also working with the Canadian Council of Nurse Regulators to explore crossjurisdictional
licensure to ease barriers for the movement of nurses between jurisdictions. This
step will facilitate the deployment of nurses to communities and areas which may require surge
support.
An interdisciplinary model of care is in development which will make appropriate use of other
health care professionals in the delivery of health care services, including but not limited to
paramedics.
Business Continuity Plans are under review to better respond to situations that could be caused
by or result in a shortage of health care professionals. These plans are being revised to provide
better guidance in the event of a nursing station closure.

If pressed on continued Nursing Shortages impacting nursing
station closures in First Nation communities:
• The Government of Canada and the Professional Institute of the
Public Service of Canada have reached an agreement to
increase the existing recruitment and retention allowances for
Indigenous Services Canada (ISC) nurses working in remote and
isolated communities.
• The department has developed a Nursing Health Human
Resources Framework aimed to comprehensively bolster
recruitment and retention of nurses.
• This framework will guide the implementation of plans
established under five specific commitments:
o Talent Acquisition and Management;
o Modernize the Practice Environment;
o Ensure the Well-being of the Workforce;
o Become a Labour Workforce Influencer; and
o Maintain a Nimble and Agile Surge Response

If pressed on current Nursing situation in Alberta
• Indigenous Services Canada funds or directly delivers some
Primary Health Care Services on Reserve in Alberta.
• The Region delivers services in four Northern on reserve
facilities with a Nurse led model of care, augmented by
paramedics and supported by fee for service physicians.
• When public servant positions cannot be filled, the region works
to augment these services through external contracts.