Federal plan's cap on coverage for incontinence care products 'inhumane' and 'offensive,' say chief, doctor

Staff at a northern Manitoba Cree Nation care home say a daily cap on coverage for incontinence products imposed by the federal government is out of step with elders' needs — something Indigenous leaders and health advocates call "inhumane" and an "offensive" example of bureaucracy disadvantaging remote First Nations communities. 

The Nisichawayasihk Cree Nation personal care home discovered after signing onto a federal plan this year that Ottawa sets a limit on products such as disposable briefs and pads at five per resident each day.

Katrina Lusung, a nurse in the northern Manitoba community, said that's led to shortages that have staff driving an hour to Thompson to buy more off the shelves of a big box store.

"We're not going to let them sit on their incontinent products when they're visibly soiled or they're fully soaked.... These residents are like my family," Lusung said.

That's a challenge the care home is encountering "because of the inadequacy of the amount that they are providing ... which is obviously not enough," she said.

The care home signed on to the federal government's non-insured health benefits program — which provides eligible First Nations and Inuit clients with coverage for a range of health benefits not otherwise covered — in March, making a switch from buying direct from a medical supply company.

The change was borne out of financial pressures, said Lusung, after the care home learned Indigenous Services Canada's First Nations and Inuit health branch covers nearly half of the costs of wound and ostomy dressings, incontinence products and more for some on-reserve long-term care facility residents. 

But the care home wasn't aware of the five per day limit until after it received an initial three-month shipment of supplies.

The average number of disposable briefs or pads NCN care home residents go through a day is more than double that, due to a variety of conditions that may cause incontinence, said care home executive director Jessie Horodecki.

"They're saying each resident shouldn't need more than five incontinence products a day," she said. "We're here, we work with our residents, we see this every day. We need minimum 12 per resident every day." 

Indigenous Services Canada spokesperson Jacinthe Goulet said the 24-bed NCN facility is jointly funded by the federal department and Manitoba Health.

Goulet confirmed Indigenous Services sets "frequency and/or quantity limits on some products" based on "consultation with health professionals." 

Nisichawayasihk Cree Nation Chief Angela Levasseur said the five per day limit "does not make any sense."

"It would be inhumane and unjust to leave our citizens with this limit.... So the NCN personal care home is left footing the bill" for more, she said.