Backlog at federal Indigenous children's program leaves families to shoulder heavy bills

First Nations families and service providers are covering hundreds of thousands of dollars in health-related bills while they wait for an overwhelmed federal program to reimburse them, CBC News has learned.

Indigenous Services Canada says it is facing unprecedented demand under the policy known as Jordan's Principle — a policy that states that when federal and provincial governments disagree over which level of government is responsible for providing health or educational services to First Nations children, they must help the child first and sort out the bills later.

The situation is leaving some families waiting months for reimbursement and covering heavy bills for approved care in the meantime.

The federal government's Jordan's Principle program is supposed to take one week at most to process requests for reimbursement.

Stephanie Gay said she waited almost ten months to hear back after she applied for Jordan's Principle funding last year to cover her four-year-old son's urgently needed autism therapy.

"It was tough because my son wasn't doing any better with his speech," said Gay, a member of Michipicoten First Nation, about 20 km southwest of Wawa, Ont.

"He was at a standstill."

Jordan's Principle is named after Jordan River Anderson of the Norway House Cree Nation, who died in 2005 at the age of five in the midst of a two-year battle between Manitoba and Ottawa over who would pay for his care.

The House of Commons adopted the principle in 2007 and the government launched a program at Indigenous Services in 2016 to compensate qualifying families for health and therapeutic services for their children.

Gay writes Jordan's Principle applications for a living and distributes funding in her job at the Waabinong Head Start Family Resource Centre in Sault Ste. Marie, Ont. She said the application process is too onerous for families.

"They're already dealing with financial stress and then Jordan's Principle is expecting them to pay $20 to $30 for a doctor letter," she said.

Gay eventually received funding under the policy and her son Owen can now hold full conversations.

"I'm really, really proud of him," she said.

Application process 'frustrating' and 'embarrassing'

Some families wait months only to be denied funding. Others go into debt to pay for services in the hope that Ottawa will reimburse them.

Samantha Kyle had to boost her credit limit to make a $2,000 deposit, and agree to pay $325 per month for 18 months, so that her two daughters, now 13 and 14, could get braces.

"They really needed the work done," said Kyle, a member of Brunswick House First Nation, 388 km northeast of Sudbury, Ont.

"It was impacting their self-esteem. It was causing pain."

Like Gay, Kyle also helps families with Jordan's Principle referrals and applications — and even she found the process tedious and the wait stressful.

Her application for reimbursement eventually was approved — but not before she sent the federal government multiple referral letters and a personal letter pleading for funding.

"I found it really frustrating and almost embarrassing," said Kyle, a family resource consultant with Waabinong Head Start Family Resource Centre.

"I don't think that I should've had to write a letter begging Jordan's Principle to cover the funding for me."

Speech therapist says she's owed more than $500,000

In 2017, the Canadian Human Rights Tribunal ordered Canada to process such requests for First Nations children within a 12 to 48 hour timeframe and to stop imposing service delays before funding is provided.

Even if funding is approved, that doesn't mean the specialists who deliver the care get paid on time.

Alana MacIntyre, a speech pathologist who serves about 150 First Nations children in northeastern Ontario, said Ottawa owes her more than $500,000 for services dating back to 2021 — services that were approved for funding by the Jordan's Principle program.

MacIntyre has been ringing the alarm about delays for more than a year and a half. She said she complained to the Ontario Human Rights Commission last May after the issue became "insurmountable."

"This has put a lot of stress on my business," said MacIntyre, owner of Spark Rehabilitation in Sault Ste. Marie, Ont. "We can't buy new supplies for the children."

Indigenous Services Canada said it strives to pay out Jordan's Principle invoices and reimbursements within 15 days of receiving all required documentation.

MacIntyre and other service providers who are owed hundreds of thousands of dollars under Jordan's Principle said that they've always had to wait much longer than 15 days. They said they don't experience the same payment delays with other government agencies or departments, such as Ontario's Workplace Safety and Insurance Board and Veterans Affairs.

MacIntyre said she believes the problem stems in part from an "archaic system" that requires four bureaucrats to approve one invoice.

She's urging Ottawa to work with service providers on a solution. She warned that specialists frustrated with long waits for payment are starting to turn away First Nations clients covered by Jordan's Principle.

"I don't think it's fair that children suffer because the federal government has a system that doesn't work," MacIntyre said.

"It does cause systemic discrimination."

Indigenous organization puts building up as collateral

Kevin Tegosh, executive director for Waabinong Head Start Family Resource Centre, said he took the drastic step of taking out a $200,000 revolving loan on his non-profit organization's former daycare building to make sure the service providers he connects families with are paid on time.

"That way, they can do the job that needs to be done," Tegosh said.

"The children will get the services they need and we'll hopefully get that money back in time for us not to lose our building."

Tegosh said his board made the decision after a speech language pathologist, who worked with families from Waabinong, warned that they might have to leave the profession after experiencing a delay in payment.

"It's really unfair for our organization to have to put our building up for collateral," Tegosh said.

Indigenous Services Minister Patty Hajdu told CBC News she's concerned about outstanding invoices. She promised to speed up the system.

"I have been working with the department to ensure that we pull out all the stops to get service providers paid on time," she said.

Minister promises changes

Hajdu said her department is working to offer automated payments and service agreements to high-volume service providers, such as speech pathologists. She said she's hiring more staff to speed up processing and a fix could be in place within the next few months.

Since Jordan's Principle became a federal program in 2016, Hajdu said, Ottawa has approved funding for more than 2.5 million services, products and supports for First Nations children.

Over the last year, she said, the number of approved requests increased by 150 per cent — a surge she attributes to heightened awareness of the program.

Timmins-James Bay NDP MP Charlie Angus said he's convinced the problem isn't increased demand or the system itself — it's the government.

"I don't think we can put this down to incompetence," Angus said. "This is a pattern that is malevolent in nature."

Angus has been working with MacIntyre and other Jordan's Principle service providers for more than a year to sort out payment issues with Indigenous Services Canada.

"This is what racist discrimination looks like," Angus said. "This government should be ashamed."

Opposition critics blame government priorities

Elizabeth May, deputy leader of the Green Party of Canada, said she was shocked by reports of care providers going unpaid for lengthy periods.

"Leaving health care providers with hundreds of thousands of dollars in unpaid bills is to me inexplicable," said May.

In a statement sent to CBC News, the Conservative Party's critic for Crown-Indigenous relations said it's no surprise the government is failing to uphold commitments to deliver basic services and support to Indigenous children. 

"Once again, Trudeau is showing Canadians and our Indigenous communities what his priorities are through his actions," wrote Jamie Schmale, MP for Haliburton-Kawartha Lakes-Brock.

Cindy Blackstock, executive director of the First Nations Child and Family Caring Society of Canada, raised concerns with the Canadian Human Rights Tribunal about Jordan's Principle last spring.

Blackstock said Ottawa is supposed to approve funding for urgent cases within 12 hours of receiving the necessary information but meets that deadline only half the time.

"This is absolutely unacceptable," Blackstock said.