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Organization: Alberta Health Services

Treaty rights, ID hurdles top concerns for First Nations voters

For some Piikani and Kainai members, the Oct. 19 referendum raises a question that isn’t on the ballot: what a provincial vote can mean for treaties signed with Canada.

For others, the harder question is whether they can prove who they are at the polls.

Both concerns came up Aug. 29, when about 30 members of the two First Nations gathered at the Fort Macleod community centre for a referendum information session billed as a chance to “be informed, be heard.”

Organizer Nicole Crowshoe Johnston’s main goal was getting First Nations voters registered and encouraging attendees to request mail-in ballots. The last day to do so is Friday, Sept. 25.

Johnston and guest speaker Stephen Carter urged a No vote on the referendum’s nine policy questions.

“Our treaty is with Canada”

One attendee asked how Alberta could enact anything affecting First Nations, “given our treaty is with Canada.”

Carter agreed, saying there “was zero discussion about what First Nations rights would look like in an independent Alberta.”

He said the referendum itself could not count as consulting First Nations.

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The premier’s office disagrees that consultation is required.

“Seven hundred thousand Albertans signed petitions asking for a referendum on this issue. The referendum question does not trigger any duty to consult,” Sam Blackett, press secretary to the premier, said in a statement to Shootin’ the Breeze.

First Nations have already taken the argument to court. Johnston said they could not rely on a few chiefs to push back against the independence movement.

“We need to stand behind the chiefs,” she said, referring to court action by the Chiefs of the Blackfoot Confederacy over treaty rights and the Crown’s duty to consult.

On May 13, the Court of King’s Bench sided with Piikani, Siksika, the Blood Tribe and Athabasca Chipewyan First Nation, quashing the chief electoral officer’s decision on Mitch Sylvestre’s separation petition on treaty rights and duty-to-consult grounds.

The province and Sylvestre appealed. The Alberta Court of Appeal granted a partial stay allowing signature verification to continue. On July 24, Elections Alberta declared the petition successful, with 222,597 verified signatures, more than the 177,732 required.

Normally, a successful petition on a constitutional question goes to the justice minister, who must refer it to cabinet for a referendum before the next provincial election. Elections Alberta says those steps are on hold pending direction from the Court of Appeal.

Sylvestre’s petition asked: “Do you agree that the Province of Alberta should cease to be a part of Canada to become an independent state?”

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That question is not on the Oct. 19 ballot.

Question 10, which is on the ballot, is not a vote to separate.

It asks whether Alberta should remain a province, or whether the provincial government should begin the constitutional process required to hold a later, binding referendum on separation.

Johnston said that even if the separation question were overturned, the Oct. 19 vote and its other questions will go ahead.

Proving who you are

Several attendees described difficulties with recent changes to Alberta’s ID and driver’s licence rules. One man said his federally issued Indian Status card was not recognized when he sought a provincial ID card.

Others cited new costs including a $100 fee to replace an expired licence, plus the expense of obtaining birth certificates and marriage licences, especially for those who had lived in other provinces or the United States.

Attendees also shared practical help. One pointed to the ID program at Chinook Regional Hospital in Lethbridge. According to Alberta Health Services, it runs Wednesdays and Thursdays from 8 a.m. to noon, helping homeless, at-risk and recently housed people, as well as others served by AHS programs, get Alberta ID and health cards.

Another said people living on reserves can get help proving their identity at home. Elections Alberta’s voter brochure confirms that voters on a reserve or settlement can have an attestation filled out by “a person in a position of authority,” such as a chief or chair, office administrator or elder, who can confirm their identity and where they live.

Johnston urged attendees to request mail-in ballots to avoid long lines, and volunteers with laptops helped people register on the spot.

“Who might be next”

Other worries went beyond the ballot box.

One senior who shares a Calgary rental with two grandchildren in post-secondary studies said the family pays $3,500 a month for rent and utilities.

“On my pension, it’s a real struggle to cover food and other basic expenses,” she said. “Even getting food from the food bank is tough as it is often old and mouldy.”

Another attendee raised Question 4, which asks: Assuming that all Canadian citizens and permanent residents continue to qualify for public health care and education as they do now, do you support the Government of Alberta charging a reasonable fee or premium to individuals with a non-permanent immigration status living in Alberta for their and their family’s use of the health care and education systems?

She said that if Albertans vote to charge immigrants for health care, Indigenous people could be next, citing relatives in the United States who became homeless after being unable to pay for care.

“When we start excluding people from services based on race, we have to be careful of who might be next,” Carter said.

Who ran the session

Johnston is a Calgary resident who describes herself as a community advocate with roots in Piikani Nation.

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She is inspired by Tania Cameron, an Anishinaabe woman from Ontario who launched First Nations Rock the Vote in 2015. Cameron announced on Facebook Sept. 2 that Treaty 8 had hired her to educate members and mobilize communities for the Alberta referendum.

Carter has managed campaigns across the political spectrum, including for former Wildrose leader Danielle Smith, former premier Alison Redford and Calgary mayors Naheed Nenshi and Jyoti Gondek. He recently launched Alberta’s Voice. The registered third-party advertiser has raised more money than any other referendum campaign to stay in Canada.

Carter’s slogan sums up his position: Stay in Canada. Vote No to the Nine.

Though the session was promoted as a chance to receive information, Carter urged a No vote on all nine yes-or-no questions rather than explaining each one.

“If any option takes three lines to express, vote against it,” he told the audience, a line he returned to several times.

“I don’t trust Danielle Smith to do it right,” Carter said. “The nine questions remove us from Canada. They are separation questions under the guise of other topics.”

Blackett said the questions grew from the government’s Alberta Next town halls, and that “Albertans’ frustrations have been fuelled by the last 10 years of disastrous policies from Ottawa under Justin Trudeau that hurt Alberta’s economy and broke the immigration system.”

“During the Alberta Next town halls, Albertans made it clear that the status quo cannot continue. Albertans have demanded real change, and these nine questions are how we deliver it,” he said.

“Our government has been clear: we support a strong and sovereign Alberta within a united Canada. This means Alberta remaining a province of Canada while advancing provincial autonomy and fighting to undo Ottawa policies that harm Albertans and intrude on our constitutional rights.”

How to vote

The referendum is Oct. 19. Voters can cast ballots in person on voting day, at an advance poll, or by mail-in special ballot.

Special ballots must be requested by Sept. 25 and received by Elections Alberta by Oct. 16.

All 10 questions, and information on requesting a special ballot, are on Elections Alberta’s website at elections.ab.ca.

Related stories

‘Historic victory’ for Piikani as court quashes separatist petition

Piikani Nation welcomes court’s pause of separation referendum process

Treaty chiefs protest separatism at legislature rally

Alberta Separation | Independence | Bill 54, Citizen Initiative Act, Duty To Consult, First Nations, Referendums, Treaty Rights, Voter Identification, Voter Registration

The Alberta Health Services logo above text that reads "New hemodialysis unit at Chinook Regional Hospital." There are hands holding a paper cut out of kidneys next to the text.

More home dialysis among goals of Lethbridge unit expansion

Southern Alberta’s kidney-care system is getting more room to grow as cases of advanced kidney disease have risen by 20 per cent over the past five years.

A new hemodialysis unit at Chinook Regional Hospital in Lethbridge increases weekly treatment capacity by 25 per cent, while an expanded kidney-care clinic gives patients more options for home-based dialysis.

The province has invested $23.4 million in the expansion, increasing the number of treatment stations at the hospital from 24 to 30 and allowing the hemodialysis unit to support up to 180 patients each week.

The expansion is more than a Lethbridge project. It is part of a regional kidney-care system that serves patients from Pincher Creek, Crowsnest Pass, Fort Macleod and other surrounding communities.

For rural patients, distance is part of the picture. Hemodialysis is typically needed three times a week, and the drive to Lethbridge is about 100 kilometres each way from Pincher Creek and about 150 from Crowsnest Pass.

Although there are dialysis centres in Blairmore and Fort Macleod, patients typically receive their first few treatments in Lethbridge before they can transition closer to home. The Lethbridge expansion does not add spaces at the rural centres, but growth in home dialysis could let more patients avoid the drive.

Shakhawat Hossain, patient-care manager with Alberta Kidney Care South, says the larger Lethbridge unit is important because patients starting dialysis need closer monitoring during the first few weeks.

“Usually when we start this treatment, especially the hemodialysis treatment, we try to keep them in our bigger centre, and our bigger centre is Lethbridge for this area,” he says.

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Once patients are stable, the care team can move them to a rural centre, based on where they live and available space. Crowsnest Pass Health Centre and Fort Macleod Health Centre are the two rural options in the area.

Fort Macleod has capacity for 38 patients, while Crowsnest Pass has capacity for only five, Hossain says.

Staff settle into new shared space

The Lethbridge unit, which opened in late July, “has been good so far,” Hossain says.

“We’re adjusting some things here and there, and finding out what’s been working, what’s not, and working with the rest of the team, making sure that everybody is satisfied and making sure that we provide the best care possible.”

The new unit also brings staff together in one location. Previously, the dialysis team worked in a unit outside the main area, which made communication between nurses and other staff more difficult, Hossain says.

The new space is brighter and larger, allowing staff to work more closely and support each other during patient care.

A system under growing pressure

Hossain says the services offered have not changed. What has changed is the unit’s ability to keep pace with a growing patient population.

The Lethbridge centre was not over capacity, but he says it was getting close.

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“Even in the next five years, if our number goes to 160, 170, we’re ready for it,” Hossain says.

Planning for the new unit factored in projected demand across the wider region, which includes Taber, Cardston, Pincher Creek, Crowsnest Pass, Fort Macleod and Picture Butte, among others.

Increasing the number of patients who can be treated at home will be a key measure of the program’s success, Hossain says.

Patients can choose between two options: peritoneal dialysis and home hemodialysis. The kidney-care clinic has four clinical rooms and five treatment areas, and supports both.

“Over the coming months, we’re looking to see if we can increase our home modality capacity so that we can have more and more patients receiving their treatment in their home,” Hossain says.

Alberta Health Services will also track patient comfort, treatment effectiveness and staff satisfaction in the months ahead, he adds.

The home-based approach could also help reduce pressure on hospital-based care, although Hossain says it is too early to tell whether the new unit has affected emergency department wait times or patient flow.

How patients get access

Patients with chronic kidney disease are followed regularly through the clinic. When a nephrologist determines a patient needs dialysis, a modality team explains the options.

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After discussion with their care team, patients can choose between peritoneal dialysis, home hemodialysis or in-centre dialysis, depending on what fits their needs.

Province highlights closer-to-home care

In a July 30 media release, Adriana LaGrange, Alberta’s minister of hospital and surgical health services, framed the expansion as part of the province’s push to deliver care closer to home.

Martin Long, minister of infrastructure, said the new renal program providing home-dialysis training supports a service many Albertans rely on multiple times a week.

The province says the $23.4-million investment is part of broader health-care infrastructure spending in southern Alberta.

It also includes $59 million over three years for cardiac services at Chinook Regional Hospital and Medicine Hat Regional Hospital, and $74 million over three years for a new health centre in Cardston.

Dialysis, Home Dialysis, Kidney Disease