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First Nations Health Council Chair Report – Fall 2018

Date:

Since June 2010, it has been my honour to serve as Chair of the First Nations Health Council (FNHC). I am pleased to announce I was just re-elected for another term. BC Chiefs challenged the FNHC to negotiate a tripartite agreement that resulted in improved services, secured long-term funding, and improved health outcomes.

We met that challenge and in 2011 – BC Chiefs renewed our mandate and tasked us to provide leadership, oversee transformation of the health system, make progress on the social determinants of health, and to be advocates. In 2012, BC Chiefs gave us direction upon the structure of the First Nations Health Authority (FNHA). We worked with the FNHA CEO as members and appointed the FNHA board of directors and supported the building of the FNHA.

Six years ago, we began to transition away from Health Canada to the FNHA.  As we wrap up the work on Non-Insured Health Benefits (NIHB) transfer, we will complete transition.  Our focus is now on transformation of the health system, making progress on the social determinants of health, and advocacy.

Our communities and our Nations now have the opportunity to redevelop their Nationhood and achieve a Nation-to-Nation relationship with Canada. BC Chiefs gave us clear direction with setting standards such as the 7-Directives. Directive #1 – Community-driven and Nation-based underpins our work. In transforming mental health, we are calling upon Chiefs, Leaders, and Caregivers to work together in ways that they may not have for a long time. Change is not easy, even when that change is good for us.  The FNHC will need to develop strategies and approaches to support this work.

 

Roadmap to Nation-to-Nation

At the Federal Deputy Ministers & FNHC table held June 29, 2018 in Ottawa, we discussed the challenges and the opportunities of achieving a Nation-to-Nation relationship. We had a lively, candid, and respectful dialogue. There was general agreement to the notion that we should develop jointly a Roadmap to Nation-to-Nation.

This roadmap would identify the challenges/barriers and the opportunities. The FNHC Partnership Working Group (PWG) is going to Ottawa in mid-October to meet senior officials. We will meet with Chiefs of Staff and officials from PMO, Treasury Board, and Finance.  We will begin to develop a roadmap.

 

FNHA – FNHC – FNHDA Joint Planning August 14-15-16

The August FNHA – FNHC – FNHDA joint planning session was productive and positive. Our discussions on the Mental Health Transformation work created an opportunity to air out fears and concerns. After airing out fears and questions – we began to see the possibilities. This process works well. On the 3rd day, we carried out ceremony to lift our spirits and take care of our family.

 

Tripartite MOU on Mental Health Transformation

Our Secretariat team and the FNHA teams have been working closely together to complete the implementation plan for the Tripartite Partnership to Improve Mental Health and Wellness Services and Achieve Progress on the Determinants of Health and Wellness MOU signed on July 26th. It is nearly finalized and ready to be shared publically.

This MOU on Mental Health Transformation calls for Nations to work together with all of their communities. Some Health Directors have expressed concerns that their Chiefs do not meet regularly and have not worked together for some time. Others expressed concern that their Chiefs are in conflict over various issues. We will need to find ways to encourage and support leaders coming together for this work.

 

Cannabis

FNHA Non-medical Cannabis Information for First Nations: www.fnha.ca/cannabis

In late June, the Government of Canada passed legislation to legalize cannabis. The Province of BC is working on legislation. At the last FNHC quarterly meeting, we heard presentations from Canada, the Province of BC and the FNHA on cannabis. We will begin a dialogue on this issue. We will also look at how we can begin to inform our Chiefs and Leaders during our upcoming regional engagements.

The FNHC recognizes the autonomy and self-determination inherent to First Nation communities and, specifically, the rights of communities to choose how to address cannabis in their territories. FNHC favours approaches that minimize the negative health impacts for individuals who voluntarily choose to use cannabis, and which minimize the promotion of cannabis use to children and youth. We approach this work with a spirit of shared responsibility – family members, community leaders, and health system partners all have a role to play.

The FNHA will be engaging with First Nations in BC through the fall regional caucus sessions. The FNHA has posted their health information on cannabis online at: www.fnha.ca/cannabis. For First Nations interested in providing feedback about cannabis and health, there is an online survey that can be taken on the FNHA website.

 

Implementation Committee

Health Canada (now Indigenous Services Canada), the BC Ministry of Health, FNHA and the FNHC established a governance committee to oversee the implementation of our 2011 BC Tripartite Framework Agreement on First Nations Health Governance. We are approaching the conclusion of this committee and are now considering the next iteration and work of this tripartite governance committee.

Our key and founding documents go back to 2005, 2006, 2007, 2010, 2011 and 2012.  On September 19, 2018, the Implementation Committee decided to work together to refresh our tripartite health plans and partnership accords. We want to build upon the progress made by each of the partners by setting out priorities for transformation, improving services, and strengthening and growing our partnerships with regional health authorities, Ministries and Departments.

As we begin to work together on renewing these key documents, we will be working with the FNHC and the FNHA to ensure that we leave no one behind.

 

Secwepemc Nation Stsmemelt MOU

Kukpi7 Wayne Christian invited me to attend the signing of this MOU in July during the AFN AGM held in Vancouver. I attended and witnessed the signing of an MOU on children and family services jurisdiction.  The Secwepemc Nation wants to build from the Splatsin model of jurisdiction. The Governments of Canada and BC have agreed to work with the Secwepemc Nation.

The First Nations Leadership Council with its partners on the Tripartite Working Group on Children and Family Services held a two-day meeting on September 26-27 in Richmond. The FNLC set the agenda that minimized presentations and maximized small group discussions. It was a productive format and there was a great dialogue. Kukpi7 Christian presented the Secwepemc Nation Stsmemelt MOU at this meeting. This presentation generated much excitement. The Wet’suwet’en Nation is working in partnership with the Secwepemc Nation on jurisdiction for children and families.

 

Matriarchs, Grandmothers and Aunties

During the First Nations Leadership Council meeting on children and families, I spoke with Chief Harvey McLeod. He shared with me a document – The Upper Nicola “Grandmothers Declaration.” It is a simple and yet powerful declaration.

Some time ago, our sister Gwen Philips talked about the role of Grandmothers. She raised the idea of the FNHC finding a way to support the Grandmothers to reclaim their role. We need to give some consideration to this idea and how we may take action to realize our Vision Statement – “Healthy, Self-Determining, Vibrant BC First Nations Children, Families, and Communities.”

 

Regional Partnership Accords

The Fraser Salish Partnership Accord and the other regional partnership documents are being evaluated as part of our 5-year evaluation. This review is an ideal time for the FNHC as one of one, three of three (regional), and fifteen of fifteen (provincial) members, to make certain that we are approaching our work in similar ways. Let us find the time to explore best practices from each of our regions and as we renew our regional partnership accords that each region is making progress on our shared priorities.

 

Partnerships

There is so much work to do. There are many organizations doing work. We need to find ways to coordinate our efforts. If we do not work together, we may prevent progress or create unnecessary conflict. We need to find time to develop a strategy on partnerships. We will need to develop a strategy and then bring it to our respective partnership tables with the Deputy Ministers.

 

Conclusion

Eight years passed quickly – while we have made significant progress there is much work to do. We should enjoy and celebrate the 5th birthday of the First Nations Health Authority. We should not party too long for there is much more work to do.

At times, it seems like the more we do, the more that we are expected to do. That is both the gift and the curse of leadership. By working together, we can and we will change the world in which we live.  By staying true to our mandate, staying in our lane – we will make progress to achieving our Vision Statement.  We will transform health and we will make progress on the Social Determinants of Health.

The FNHC looks forward to seeing you at our fall 2018 regional caucus sessions.

 

Grand Chief Doug Kelly
Chair, First Nations Health Council