Public Accounts committee  Like a lot of things in Canada, it depends on the province. Some provinces will reinstate health care immediately upon release if you were in that province prior to being incarcerated. If you are released to a province you weren't residing in before, some provinces will do the three-month coverage and other provinces won't.

Public Accounts committee  We do provide limited health services in the community, recognizing gaps in care.

Public Accounts committee  We spend approximately $16 million a year on health services in the community. That's above and beyond what provinces are providing. Of that $16 million, $13 million goes directly to mental health services. The vast majority is focused on the mental health needs of the offenders.

Public Accounts committee  The expenditures? Yes.

Public Accounts committee  For sure we could do it region by region for the five regions. I'm not sure if we could do it province by province.

Public Accounts committee  Yes, absolutely.

Public Accounts committee  We provide essential health care to incarcerated individuals just like provincial health care plans are provided to the rest of Canada. On release, we prepare discharge planning that's relative to the health needs of the patients, because on release to the community, they become included in the Canada Health Act and the provinces become primarily responsible for their health care.

Public Accounts committee  Problematic substance use is a very complex health need. We're fully committed to implementing all pillars of the Canada health strategy, which includes the enforcement elements that Commissioner Kelly spoke about and harm reduction such as take-home naloxone and treatment. Whether an offender is using or not while they're incarcerated, they can still have a substance misuse problem.

Public Safety committee  I think one of the unique things about working in the correctional system is that the interdisciplinary team for any patient includes correctional officers, parole officers and elders, because we all need to work collaboratively with the patient on the same treatment goals. We certainly define interdisciplinary teams very broadly based on our environment.

Public Safety committee  We're consistently and constantly reviewing the training we provide to staff. A lot of the training that we previously provided as stand-alone courses is now integrated into existing courses, integrated into the first course the correctional officers receive. We've integrated mental health training into that course so that when you're learning about static and dynamic factors, you learn about how those are impacted for people with mental health needs.

Public Safety committee  From a recruitment perspective, it's sort of all of the above. We hire new graduates and we hire staff who have experience in forensic systems from emergency rooms. We hire a variety of staff who are interested in working with vulnerable populations, and we have an orientation program for health professionals that responds to fill in their knowledge gaps based on their education and past experience.

Public Safety committee  The bill speaks to the role of patient advocacy as a fundamental responsibility for all health care professionals, and then it's specific services in institutions that are designated by the commissioner. Those patient advocates and the patient advocacy role is really there to help the inmates navigate the system to understand their rights and to assist their family members as well when we're dealing with serious mental illness and trying to put together appropriate plans and treatments with the inmate patient.

Public Safety committee  The issue of stigma can be a deeply personal issue for individuals whether they're incarcerated or not. Certainly we've benefited from following the lead of the Mental Health Commission of Canada and their work to address stigma. Both for staff and inmates, we've come a long way in addressing stigma.

Public Accounts committee  We did amend the policy in August, so that women with serious mental illness or significant impairment, as well as men with the same mental health needs, are now prohibited from being placed in segregation. We've worked out the information sharing, so that the information about that prohibition on an individual, case-by-case basis is available to our operational colleagues, even when health care is in its sight.

Public Accounts committee  Certainly, we've had challenges with recruiting and retention of health professionals over the years. That's an area on which we are placing an increased leadership focus. We have dedicated health recruiters in each region. It is a recruitment but also a retention issue, and that's the piece on which we've recently made the most progress.