Thunder Bay, Ont., is a health-care hub for members of dozens of surrounding First Nations who travel to the city for medical appointments that aren’t available at home.

For years, community members relied on the city’s Wequedong Lodge for accommodation and transportation — but a lack of secure, stable funding from Indigenous Services Canada (ISC) resulted in a significant cutback in its services in April 2024.

That’s when the Sioux Lookout First Nations Health Authority (SLFNHA) stepped up to help fill the gap by launching its own medical transportation program in town.

SLFNHA supports 33 First Nations, 28 of which are remote. Since April 2024, it’s provided about 38,000 rides to patients and their family members in Thunder Bay.

But the program is ending as of April 1.

“It’s been very upsetting for us because we know this program is good. We know that it’s working. We know that we’re transporting people in the way that they need to be transported,” said Monica Hemeon, SLFNHA’s vice president of regional services.

SLFNHA says the decision “is a direct result of Non-Insured Health Benefits (NIHB) and Indigenous Services Canada (ISC) failing to fund the program proportionally to the actual, documented volume of clients served and adequate funding for SLFNHA employees along with program operating costs.”

“It wasn’t for a few months after SLFNHA was providing this service that NIHB/ISC informed SLFNHA that they were obligated to follow their funding model and complicated reporting requirements. Because of this, we are operating in the negative,” SLFNHA said in a news release on Friday.

As of April 1, Indigenous Services Canada’s medical transportation department in Sioux Lookout will provide limited taxi vouchers for those attending appointments in Thunder Bay.

According to Hemeon, this department is already strained with a high volume of requests, “and then our clients are going to be lost in the system and that’s going to be an issue.”

She’s also concerned about the lack of taxi services available in the city.

“We will, on occasion, have full plane loads of people come at the same time and we know that the taxis in Thunder Bay can’t accommodate that,” Hemeon said.

As well, patients have reported negative experiences with local taxi drivers in the past due to a lack of cultural understanding, she added.

“I think we all realize that there can be some racial profiling in the city of Thunder Bay — it’s been reported many times,” Hemeon said. “One of our biggest concerns is the appropriateness of care that our clients are going to receive, culturally-safe care.”

CBC News has reached out to Indigenous Services Canada for comment and is awaiting a response.

Concerns about layoffs, consistency of care

All of the staff at SLFNHA’s medical transportation program are First Nation members. The service’s suspension means more than 20 people are being laid off.

“Some of the comments from some of our staff have been, ‘we’ve been looking for a job in Thunder Bay for years and we’ve never even been interviewed,’” Hemeon said.

Many of the staff members have formed relationships with patients by speaking their traditional language, “communicating with our community members in a very respectful and wanted way,” said Hemeon. 

They also provide assistance with luggage, understanding that many patients stock-up on essential supplies in town that they can’t get in their First Nation, she explained.

If a patient receives a referral during their appointment for further testing, SLFNHA tries to get them there that day rather than having them fly back to their community and have to return to Thunder Bay another time.

However, the health authority has received pushback from ISC for this “because it wasn’t a pre-approved medical transportation.”

“We want to really accommodate that because it’s best for the clients. It’s also, in the end, best for Indigenous Services Canada to not have to pay the thousands of dollars it costs to bring someone out for testing,” Hemeon said.

In her view, ISC needs to recognize the benefits of having a local transportation program tailored to patients’ needs.

“People were very safe, they felt comfortable with the drivers, they felt comfortable with the support they were receiving,” Hemeon said. “It’s all very sad.”