Dear Respected Chiefs and Leaders,
As representatives to the First Nations Health Council (FNHC), we are pleased to share this update on recent developments related to the work of the FNHC.
New Partnership with Canada:
The federal government has established an ambitous agenda for change. The federal government has committed to a renewed Nation-to-Nation relationship with Indigenous peoples on the issues that matter most – issues like housing, employment, health, community safety and policing, child welfare, and education. These commitments come as the result of many years of advocacy and calls to action by our leaders. These commitments are the acknowledgement that the status quo is no longer acceptable and that we will accept nothing less than transformative change in our communities.
On February 14, 2017, the FNHC and the Minister of INAC signed a Memorandum of Understanding (MOU) to engage First Nations in BC on ways to improve outcomes for First Nation children, youth and families. This agreement is about engagement. This agreement is about creating forums for First Nations to engage in direct dialogue with INAC on services for First Nation children and families.
To be clear, the FNHC is not negotiating the jurisdiction or transfer of services with Canada and BC. In May 2011, BC Chiefs endorsed 7 Directives to guide the work of the FNHC. As per Directive 6, the FNHC must be without prejudice to First Nations interests. This means the FNHC will never impact on Aboriginal title and rights or the treaty rights of First Nations, and is without prejudice to First Nations interests with respect to any self-government agreements or court proceedings. As members of the FNHC, each of us come from a First Nation. Each of us understand the significance and purpose of this directive. The FNHC exercises due diligence and care to ensure that we do not prejudice First Nations interests.
This agreement presents a pathway for reform. It stands as a commitment to engage in a process that is Community-Driven and Nation-Based, ensuring each Nation has the time, capacity and resources to fully contribute. It is a commitment to engage in a way that is comprehensive, inclusive and community-led, ensuring First Nations are full and equal partners in the development of new policy, structures and programs in BC. It provides a path for First Nations to engage in direct dialogue with INAC on needed investments in capacity and community-based prevention services. It ensures each Nation can advocate for resources to design systems of care that advance their own vision, traditions and values.
Mandate of the First Nations Health Council:
As one of the four entities established by BC First Nations to improve health outcomes, the FNHC is a 15 member political and advocacy body that is appointed by and accountable to Chiefs in each Region. In May 2011, Chiefs endorsed Resolution 2011-01 to establish the new health governance structure.
Chiefs called upon the FNHC to provide political leadership in the implementation of the tripartite health plans and agreements, support health systems transformation, and to build partnerships to make progress on the social determinants of health.
The FNHA has entered its third year of operation and is now setting the stage for the transformation of health programs and services in full partnership with First Nations. With transfer complete, the FNHC is building partnerships with the federal and provincial government and other First Nation organizations to address broader issues that impact health.
As per Resolution 2011-01, the FNHC is mandated to develop relationships and alliances with other First Nations organizations, provincial Ministries and federal Departments to achieve progress on the social determinants of health.
A key directive for the FNHC is to foster meaningful collaboration and partnership to achieve progress on the social determinants of health. This directive acknowledges that no single authority, agency or organization has the capacity to meet the needs of First Nations children and families. We must find ways of working together. The FNHC has engaged other First Nations organizations to discuss opportunities for collaboration.
In October 2015, the FNHC and FNLC agreed to work together on the social determinants of health. The FNHC and FNLC acknowledged that each entity has a responsibility to advocate and to improve outcomes for First Nation children, youth and families. While each entity has distinct governance structures and mandates, the FNHC and FNLC will work together to ensure unity in our advocacy and maintaining a high standard for engaging each Nation on strategic direction.
In the fall of last year, provincial Deputy Ministers and Assistant Deputy Ministers from the Ministries of Children and Family Development (MCFD), Ecucation, Advanced Education, Justice and Public Safety engaged each Regional Caucus on issues impacting the health and wellness of our people. In many cases, this was the first time senior decision-makers from the Government of BC heard directly from First Nations Chiefs, health leads and service providers. These sessions were constructive with clear recommendations to improve the systems that serve our people.
On February 21, 2017, the Government of BC made public its Budget and Ministry Service Plans for the year ahead. A key feature of the MOU between BC and the FNHC signed in March 2016 was the commitment for provincial Ministries to include the input and recommendations of the Nations in Ministry Service Plans starting in 2017/18. We are pleased to report that each of the Ministries that participated in the Regional Caucus have included new commitments to improve outcomes for First Nations children, youth and families. New commitments include:
- Ministry of Children and Family Development to provide resources and direct supports to families and communities to ensure that children and youth have every opportunity to safely remain at home with their families
- Ministry of Children and Family Development to focus on seeking permanent living arrangements outside the child welfare system with a focused effort on improving permanency planning and cultural connections for Indigenous children and youth already in care
- Ministries of Justice and Public Safety to improve access to services in rural and remote communities with a stronger focus on community-based prevention initiatives and alternate dispute resolution.
- A government-wide approach to address mental health and wellness and substance use.
This represents a new way of working. For the first time, BC First Nations were meaningfully involved in the planning of the provincial government. While more change is needed, this is an example of how we can bring conversations closer to home and influence the change we wish to see.
As we look ahead to the Regional Caucuses in the spring, we want to support a similar dialogue between First Nations and the federal government.
First Nations in BC are diverse. Each of our Nations is at different stages on their journeys of self-determination. Each of our Nations has distinct visions, perspectives and priorities when it comes to reforming the systems that currently serve our children and families. The current situation is complex. While we are diverse, we all agree that First Nations are best positioned to provide for the safety and wellbeing of their children and families. While each of our Nations will pursue its own path, we are united by a shared vision of healthy, self-determining and vibrant First Nation children, families and communities. It is our hope that we can come together as Nations to share our expertise and bring the best of our thinking to the table as we break the cycle and reclaim the wellbeing of our children, families and communities.
Signed by Grand Chief Kelly, Ernest Armann, Bev Lambert, Gwen Phillips and Nick Chowdhury
Social Determinants of Health:
The First Nation Perspective on Wellness is a visual depiction of our vision of health and wellness. The fifth circle depicts the social, cultural, economic and environmental determinants of health. In this way, health is an outcome. It is dependent on a number of factors, including early childhood experiences, personal health practices and coping skills, income and employment, health services, gender, genetics, education and social support networks. To improve outcomes, it is important to collaborate across social sectors to influence the factors that impact health.
Read more on the Social Determinants of Health in this Backgrounder (PDF 502 KB)
This backgrounder provides more information on the purpose and intent of the agreement recently signed by the First Nations Health Council (FNHC) and the Minister of Indigenous and Northern Affairs Canada (INAC) related to services for First Nation children and families in BC.
Purpose of the Agreement:
The MOU with INAC sets the table for a comprehensive, inclusive and community-led process to improve social services accessed by First Nation children, youth and families in BC
Focus on Root Causes and Social Services:
To reduce the number of First Nation children being taken into care, we must tackle the root causes. This includes mental health and wellness, substance use, intergenerational trauma, inadequate housing, food insecurity and poverty.
The MOU with INAC creates space for communities to talk about the root causes and advocate for new investments in community-based initiatives aimed at tackling them.
Mandate and Process:
The FNHC is a province-wide political and advocacy body. The 15 members of the FNHC are appointed by and accountable to the Chiefs through their respective Sub-Regional Caucuses, Nations and Regional Caucuses.
The FNHC takes its direction from First Nations through discussions at Regional Caucuses and the Gathering Wisdom for a Shared Journey forum. In May 2011, BC Chiefs endorsed Consensus Paper 2011 and Resolution 2011-01. This mandated the FNHC to continue as a provincial-level political and advocacy body to:
- Provide political leadership for the implementation of the health plans
- Support First Nations to achieve their health and wellness priorities
- Build partnerships to make progress on the social determinants of health
- Ensure communication, transparency, cost-effectiveness and accountability of the FNHC to First Nations
The First Nations Health Authority (FNHA) is responsible for planning, delivering and funding all of the health programs previously provided by Health Canada. While the FNHA and the FNHC are partners, each entity has a distinct mandate and role. The FNHA is responsible for operations. The FNHC is responsible for political advocacy and oversight. This structure ensures there is a clear separation of political and operational roles.
Not About Jurisdiction:
The FNHC is not negotiating jurisdiction or assuming new authority for children and family services. The FNHC exercises due diligence and care to ensure that processes and agreements are without prejudice to First Nations interests.
Before, during, or after the engagement, Nations may decide to negotiate jurisdiction with Canada and BC directly. This work rightfully belongs to the Nations.
Not About the Transfer of Services:
This FNHC has not discussed the transfer of children and family services with the Government of Canada or the Province of BC. The FNHC or FNHA is not taking over the administration of the First Nation Children and Family Services Program from INAC.
More Resources and Capacity Coming:
No FNHA health funding will be used to resource the engagement process referenced in the MOU with INAC. The FNHC and INAC have agreed to find new funding to support the engagement process. This new funding stream will be used for engagement purposes only. It does not take away from existing funding available to communities for health, children or families.
The FNHC has heard from many First Nations that capacity is an ongoing challenge. The FNHC has communicated clearly to government that more resources are required to support discussions at the Nation level.
No Impact on Canadian Human Rights Tribunal Decision:
The Government of Canada must meet its obligation to meaningfully invest in and reform its discriminatory practices as per the 2016 Canadian Human Rights Tribunal decision. The MOU with INAC will not interfere in any discussions that Nations or their Delegated Aboriginal Agencies may be having directly with the Government of Canada on investments or delivery of services.
The MOU with INAC will create space for discussion directly with BC First Nations on community-based preventative services. It will also provide a platform for a broader discussion on needed investments in the long-term.
Commitment to Co-Develop New Programs, Structures or Policies:
A key commitment in this agreement is that BC First Nations are full and equal partners in the development of any new policy, structures or processes in BC.
This means INAC must engage meaningfully with the Nations to ensure program reforms support community-based prevention services. This includes the creation of a stronger continuum of care for children and families in BC.
This Work Belongs to the Nations and is Best Discussed in the Regions:
The MOU with INAC will bring discussions closer to home at both the sub-regional and regional level. Through this agreement, Nations will have the opportunity to engage the Government of Canada directly on their priority issues. Through engagement at Sub-Regional Caucuses, Nation Assemblies and Regional Caucuses, Chiefs, caregivers and advocates will be able to engage directly with senior government officials on their own plans for the design and delivery of preventative services for children, youth and families.
Each Nation is at a Different Stage of Development:
First Nations in British Columbia are diverse and the current situation is complex. First Nation children and families are too often served by complex systems, driven by a mix of legislation, policy and standards developed and delivered by different levels of government. There are Nations with years of experience delivering a full range of health and social services, including Delegated Aboriginal Agencies. There are Nations who have established non-profit organizations that now provide preventative services to their communities. There are some Nations that are only served by the Ministry of Children and Family Development. Each Nation is at a different stage when it comes to children and family services.
Building Consensus on New Models:
The FNHC and INAC have agreed to support a Community-Driven, Nation-Based engagement process over a period of 18 months. The engagement process will be consistent with the BC First Nation endorsed ‘engagement and approvals pathway.’ This process will include Regional Caucuses and a minimum of one province-wide Gathering Wisdom for a Shared Journey Forum. The goal is to build broad consensus on reforms to services and related funding, policy and programs.
Commitment to Address Inequities in Funding, Policy and Programs:
The decision of the Canadian Human Rights Tribunal was clear that the funding formulas used by INAC do not address the real needs of communities. Through this process, there is an opportunity to talk about these inequities and develop approaches that provide more money for prevention, greater flexibility for Nations to design and delivery prevention services, and greater accountability of Canada and BC to BC First Nations.
Find more details about the First Nations Health Governance Structure in BC here (PDF 950 KB)