AADAC centres protest

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For 10 years, Health Canada has covered room and board fees for First Nations treaty clients attending addictions treatment at residential centres operated by the Alberta Alcohol and Drug Abuse Commission (AADAC). Now the feds have had a change of heart. They won't to pay the fees, and Nick Hossack, director of prevention and promotion overseeing the National Native Alcohol and Drug Abuse Program (NNADAP) is taking the heat.

AADAC, which operates both referral agencies and residential treatment centres (26 in total), does not fund on-reserve residential treatment programs and NNADAP is not mandated to fund off-reserve programs.

Hossack said paying the room and board fees that AADAC implemented in 1993 never was within Health Canada's mandate. The only change is that with every department scrutinizing costs more closely than in the past, the federal government is enforcing policy that was already in place.

"Past practice might not have been consistent with the legality of the situation," Hossack said.

Leona Carter, the executive director of Poundmakers Lodge in St. Albert, said the $10 a day Health Canada was contributing to AADAC residential treatment centres-"less than a million a year" in Alberta-is "a minute amount when you compare the long-term costs of people suffering."

The actual room and board fee is $15 a day, and Alberta is the only province that charges clients.

Carter said her centre will lose 400 clients a year who cannot afford to pay even this amount.

Hossack said AADAC centres should be able to find ways to make up the shortfall.

"It costs over $200 a day to provide treatment, generally. So what we're talking about is less than five per cent of the cost of providing treatment. I'd be hard pressed to believe that's going to mean the severe dislocation for any particular centre. If we look at the number of clients and then over the year you multiply by ... say $300 for round numbers, that couldn't possibly be a serious source of revenue for a centre. We're talking multi-million dollar centres here. This is not core funding."

Carter alleged the federal policy shift has less to do with tightening departmental belts and more to do with a study that showed NNADAP centres have had a significant drop in admissions over the past five years.

She said because of the nature of Health Canada's contribution agreement with NNADAP, it costs the same to operate NNADAP centres "whether you have one client or 20 clients." She said NNADAP wants to make better use of their treatment centres to improve the bottom line.

The problem with that is, "You are taking the individual rights of the person to be able to choose where they want to go get treatment-you're removing that from them. It's a constitutional right, and that has been removed from treaty people."

Carter said the only places treaty people can now get help for addictions without paying room and board are NNADAP centres situated on-reserve.

AADAC directors say many urban Aboriginal people have never lived on reserve and have no desire to go to one that may be a long way from their support system of family and friends. There was also the suggestion that reserves are perceived by some people as being the source of, or a contributor to, addiction problems.

Hossack said two of their centres in particular are trying especially hard to give people support in the areas of employment and family relations, to try to ensure the treatment centre experience leads to a permanent lifestyle change.

Muriel Sikorski, director of the Bonneyville Indian Metis Rehabilitation Centre, said Health Canada's policy shift "has affected us really bad."

She said her 30-year-old facility was built on Crown land specifically for Aboriginal people, and 85 per cent of her clientele are status people.

She said these clients do not want to drive eight hours to St. Paul's Treatment Centre in Stand Off in the south. The closer NNADAP centre at Lac La Biche-"probably 200 miles away-is full, she said.

Clark McAskile, director of Action North Recovery in High Level, said Health Canada's move amounts to "denying services based on ethnic background."

He explained the Dene people prefer to come to his centre because transportation is more economical than if they attend the nearest NNADAP centre, but he has not had a Dene client since November, except for a couple who paid their own way. His clientele, which was 95 per cent Native, is now less than five per cent Native, so he has removed some of the cultural components from the program.