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First Nations Health Council and Indigenous and Northern Affairs Ceremony Marks Agreement on Improving Lives of Children and Communities in B.C.

Date:

Coast Salish Territory – Vancouver, B.C. – The First Nations Health Council (FNHC) and Indigenous and Northern Affairs Canada (INAC) have marked the signing of a recent agreement in ceremony on Coast Salish Territory in Vancouver.

The Memorandum of Understanding (MoU) is a commitment to work together, through a process of community engagement, to improve the health and wellbeing of First Nations children, youth and families in B.C. The ceremonial event follows the initial signing that took place on February 14, 2017 in Ottawa and is an integral part of bringing the agreement to life.

This agreement intends to create space for communities to engage in direct dialogue with the FNHC and INAC on funding, policy and programs that will help to shape and improve the way services for children and families are designed and delivered in the future, including to reduce the disproportionate rate of Indigenous children being taken into care. With a vision of keeping children safe and families together, one of the goals of the engagement process is to see an increase in investments for community-based prevention services.

The parties acknowledge the diversity of perspectives, capacity and priorities of First Nations to reform the systems that serve their children, youth and families in B.C. The engagement process envisioned in this agreement will be inclusive, comprehensive and community-led, providing opportunities to build consensus on new priorities, models, and processes. This process will be community-driven and Nation-based, ensuring each Nation has the time and ability to contribute fully to this conversation.

Canada and First Nations in B.C. now have the opportunity to address historic funding shortfalls and build new relationships together, ones that are based on mutual accountability, increased flexibility and greater First Nations control. The MoU provides new opportunities for communities to lead in the design, planning, and dialogue around Indigenous child and family well-being in order to address the broader social determinants of health. The primary goal is to build healthy and sustainable communities that are adequately funded to deliver culturally appropriate and safe services for First Nations children, youth and families.

Importantly, this work is without prejudice to First Nations interests and does not limit, impede, or alter existing agreements or discussions between First Nations and the federal and provincial government. This is a starting point for dialogue between Canada and B.C. First Nations, opening the door for a conversation to take place on change. It is intended to strengthen linkages between agencies involved in health, education, justice, public safety, employment and training, social services and child welfare, while acknowledging the impacts of intergenerational trauma, poverty and mental wellness and substance use on health.

Grand Chief Doug Kelly First Nations Health Council Chair
“For too long, the government took decisions about us without us. This agreement creates the space for Chiefs and leaders to engage directly with government decision-makers to transform together child, youth, and family services. Transformative change is heavy work and it requires many hands – but we can do this!”

The Honourable Carolyn Bennett, M.D., P.C., M.P. Minister of Indigenous Affairs and Northern Development
“Our priority as Canadians must be—first and foremost—the health, well-being and protection of Indigenous children. Reconciliation and its progress between Canada and Indigenous Peoples is crucial. We are proud to be working with the First Nations Health Council in British Columbia to take this step on the path forward to ensuring the program meets the needs of children, families and communities.”

The Honourable Stephanie Cadieux Minister of Children and Family Development
“This MoU is an important milestone that brings focus to our shared goal of helping to keep families together and ensuring that Indigenous children remain connected to their cultures, traditions and communities. This agreement reflects the direction in the Calls to Action from the Truth and Reconciliation Commission as well as a number of key reports and engagement processes informing positive change to Indigenous child welfare. I’m honoured to be a part of the changes we are all making — as full and equal partners — to improve the health and well-being of First Nations children, youth and families.”

To view the Memorandum of Understanding, please visit: http://fnhc.ca/2017/02/first-nations-health-council-and-indigenous-and-northern-affairs-sign-mou-on-root-causes/

Media Contacts:
First Nations Health Council 604-831-4898

Sabrina Williams – Press Secretary Office of the Honourable Carolyn Bennett 613-697-8316

Indigenous and Northern Affairs Canada 819-953-1160

First Nations Health Authority and First Nations Health Council Letter to Attendees of Gathering Wisdom for a Shared Journey VIII

Date:

January 6, 2017
Greetings and Happy New Year,

Following up on recent dialogue at the Gathering Wisdom for a Shared Journey Forum, First Nations Health Authority (FNHA) and First Nations Health Council (FNHC) offer a few points of clarification on items raised by forum delegates.

Because the focus of this year’s forum was the social determinants of health, the FNHA participated in Gathering Wisdom VIII as an invited guest of the FNHC. The intention was to discuss influencing change within the determinants of health of First Nations communities rather than FNHA service improvements.

The FNHC and FNHA respectively offer the following information in the spirit of open dialogue and continuous improvement, recognizing that we have much work to do together.

 

In health and wellness,

 

Grand Chief Doug Kelly,                                        Lydia Hwitsum,

Chair, First Nations Health Council                    Chair, First Nations Health Authority

 

 

  


First Nations Health Council

 

Misconception: Health Directors are being excluded from the health governance/transformation process by not being invited to Gathering Wisdom.

FNHC Clarification

We appreciated the active participation of over 100 Health Directors and Health Leads at this year’s Gathering Wisdom. The Gathering Wisdom forums have evolved over the years to reflect our health and wellness journey as BC First Nations.

The forum this year was different in a number of ways: 1) the forum was hosted by FNHC rather than FNHA; 2) the focus of the forum was broader than health and focused on the social determinants of health; 3). Finally, in accordance with Directive 6 the FNHC recognizes each First Nation organizes its staffing and technical supports according to its own needs and aspirations. As such, each Chief had the opportunity to invite one technical lead, such as a Health Director, to the forum.

Health Directors will continue to be active partners in the transformation of programs and services. Work that requires Health Directors, FNHA and provincial partner participation and engagement. An important upcoming opportunity is the Best of Both Worlds forum on March 1, 2017 – a conversation about quality improvements for provincial, FNHA-delivered, and FNHA-funded and Health Director-delivered programs and services.

 


Misconception:
First Nations Health Council and First Nations Health Authority are taking over Child and Family Services.

FNHC Clarification:

FNHC is facilitating conversations on the Social Determinants of Health with leadership using existing engagement pathways. The FNHC is not taking over administration of Child and Family services. The decision of how to organize in order to move forward on these items rests with First Nations leaders and in accordance with the Seven Directives.

Specifically, ​Directive #1: Community-Driven, Nation-Based; Directive #2: Increase First Nations Decision-Making and Control; Directive #4: Foster Meaningful Collaboration and Partnership; and Directive #6: Be Without Prejudice to First Nations Interests. As described on the floor at Gathering Wisdom, this is the beginning of the process using the engagement and approvals pathway that will span the next 24 months.


Misconception:
First Nations Health Council is abandoning its responsibilities in health by focusing on the social determinants.

FNHC Clarification:

First Nations Health Council has a mandate of health transformation. Social determinants of health are an important influencer of health outcomes for First Nations people. The FNHC is actively engaged with the FNHC/FNHDA/FNHA collaboration committee which guides the transformation of health services. The FNHC look forward to continuing engagement with regional caucuses to make progress on the social determinants of health agenda in 2017/2018.

 

Misconception: FNHA has cut First Nations Health Benefits funding.

FNHA Clarification:

No elements of the First Nations Health benefits program have seen a cut in funding. In fact, expenditures have increased as number of clients accessing the program continues to grow, including in the areas of patient travel meals and medical transportation.

There is still much work to be done. We encourage those with feedback about First Nations Health Benefits to fill out the Health Benefits Client Satisfaction Survey available through www.fnha.ca/benefits. For more information, please view the FNHA Annual Report Health Benefits section or the First Nations Health Benefits Annual Report: www.fnha.ca/about/governance-and-accountability/annual-reports.


Misconception:
FNHA has cut contribution agreement funding to First Nations communities.

FNHA Clarification:

Since novation in 2013, FNHA has supported year over year increases for all Set, Flexible and Block community contribution agreements of between 2.5-5.5%.  Increases for community contribution agreements in the BC region have outpaced all other regions in Canada.

 


Misconception:
FNHA has introduced generic drugs as a cost-cutting measure.

FNHA Clarification:

BC First Nations receive the same proportion of generic and brand names drugs as before transfer.

Brand name drugs are not better because they are more expensive; they are more expensive because of investments made in research, development and marketing (branding) – which increases pricing by 30 to 40 percent. Any cost savings realized by generic drugs provide the opportunity to reinvest in wellness programing for First Nations.

The FNHA prescription drug list is similar to the BC Pharmacare prescription drug list that is mandated for all citizens of BC. Most drug plans – including Pharmacare, Veterans and NIHB – switch coverage to the generic version of a drug once the patent on the brand name drug has expired. To ensure optimal client safety, a drug exception process is also available.

Both generic and brand name drugs contain the same active medicinal ingredients and are equally safe and effective. Both generic and brand name drugs are tested for quality, safety and effectiveness by Health Canada.

For more information on generic drugs and the FNHA, visit our website: www.fnha.ca and search: Generic Drugs.


Question:
What is the FNHA doing about the overdose crisis?

FNHA Response:

FNHA has been actively engaged in the provincial overdose task force, presenting at community town halls on overdose and engaging in community training to prevent opioid overdose.

Over 94 First Nations Health Centres are now registered to provide naloxone kits, at no cost to First Nations, with BC Centre for Disease Control’s (BCCDC) ‘Toward the Heart’ program. Find a location here. More naloxone kit training sessions are planned.

FNHA is reaching out to communities with its new model: ‘Indigenizing Harm Reduction.’ The model uses a First Nations lens to facilitate dialogue on harm reduction practices and is provided by FNHA’s Indigenous Wellness team. The model was well received in five naloxone training sessions this fall, which reached more than a dozen First Nations communities. Due to high demand, more training sessions will be delivered. To have a presentation in your community please email Janine.Stevenson@fnha.ca.

The rate of overdose deaths continues to rise in BC. Tragically, over 760 people have died of overdose since January 2016. BC is presently averaging two overdose deaths per week.

Further information including videos, posters, information on the Take-Home Naloxone program and a list of treatment centres in BC is available here: www.fnha.ca/overdose.

Resources

‘Overdose can be Prevented’ poster: http://www.fnha.ca/newsContent/Documents/FNHA-Overdose-Awareness-Day-Poster-2016.pdf

Overdose Information and videos: http://www.fnha.ca/what-we-do/mental-wellness-and-substance-use/overdose-information#treatment-centres

Naloxone available at no cost to First Nations in BC: http://www.fnha.ca/wellnessContent/Wellness/FNHA-Nalaxone-Info-for-Community.pdf

 

How can I help keep people safe?

  • Print the attached ‘Overdose can be Prevented’ poster and post it in your community.
  • Have conversations with vulnerable people. A great opportunity for this conversation is when people pick up their supplies.

Key messages for conversations to keep people safe: 

    • Be extra careful when using – use less than you normally would.
    • Know the signs of overdose.
    • Try not to use alone. If you do, have someone check on you and have a safety plan in place.
    • Watch out for each other.
    • Call 911 quickly when you notice something isn’t right.
    • Breathe for someone that is overdosing: provide one breath every five seconds.
    • Get a naloxone kit – they are free!
  • Ask vulnerable people to spread the word within their social networks as vulnerable people often do not have a connection to health services.

Download this letter in PDF format here (218 KB)

Summary and presentations from Gathering Wisdom for a Shared Journey VIII

Date:

Gathering Wisdom for a Shared Journey VIII took place on November 30 to December 2, 2016 at the Sheraton Wall Centre Hotel in Vancouver, hosted by the FNHC. Delegates took part in a governance forum around the social determinants of health – the social, cultural, economic and environmental factors that contribute to healthy communities.

The theme of the forum this year was “Learning from the Past and Planning for the Future”. This theme reflects our traditions as strong, healthy and self-determining Nations. At the same time, it is an opportunity to reflect on our shared journey in health over the past ten years. It is an opportunity to draw upon our strengths as Nations and to chart the course for the next stage of our shared journey. Most importantly, it is an opportunity for First Nations leadership to inform and shape the strategic direction of provincial ministries responsible for education, post-secondary education, justice, public safety, and children and family services.

Below are the presentation slides in PDF format.

Presentation Slides

FNHA CEO, Joe Gallagher Presentation

Dr. Perry Kendall and Dr. Evan Adams Presentation

Government of British Columbia Justice and Public Safety Sector – Richard J.M. Fyfe, Deputy Attorney General & Mark Sieben, Deputy Solicitor General

Ministry of Education – Social Determinants of Health

Terry Cross, Keynote Speaker – Decolonizing First Nations Child Welfare

Implementing the Memorandum of Understanding: A Shared Agenda for Health and Wellness – Ministry of Health

Ministry of Children & Family Development – Regional Health Caucus Sessions Summary

Communique on Gathering Wisdom for a Shared Journey

Date:

The FNHC is pleased to announce more details about the upcoming Gathering Wisdom for a Shared Journey forum. Gathering Wisdom will be hosted by the FNHC on November 30 to December 2, 2016 at the Sheraton Wall Centre Hotel in Vancouver.

The focus of the forum this year is the social determinants of health – the social, cultural, economic and environmental factors that contribute to healthy communities. The forum will build on the discussions started at the Regional Caucuses this fall and will feature presentations from provincial Ministries. The forum is an opportunity for First Nations leaders to inform and shape the strategic direction of provincial Ministries responsible for education, post-secondary education, justice, public safety, and children and family services. It is an opportunity for First Nations leaders to discuss a long-term vision and strategy to address the social determinants of health.

*Please Note: Gathering Wisdom Email Address Correction*

There was an error with the event’s email address in previous communication. Please ensure to email gatheringwisdom@pacegroup.com for registration questions.

NOVEMBER 29TH – EARLY REGISTRATION AND REGIONAL CAUCUSES 
TIMEAGENDA ITEM
2:00-6:00 pmEarly Registration
6:00-8:00 pmRegional Caucuses – Dinner and Discussion
NOVEMBER 30TH – DAY ONE
TIMEAGENDA ITEM
7:00 amRegistration Opens
7:30-8:15 amBreakfast
8:15-9:00 amWelcome to Coast Salish Territory
Morning SessionEstablishing the First Nation Health Governance Structure

· Joe Gallagher (Chief Executive Officer, First Nations Health Authority)

Towards a Ten-Year Population Health and Wellness Agenda

· Dr. Evan Adams (Chief Medical Officer, First Nations Health Authority)

· Dr. Perry Kendall (Provincial Health Officer, BC Ministry of Health)

Advancing the Shared Vision of Healthy, Self-Determining and Vibrant BC First Nations

· Shane Gottfriedson (BC AFN Regional Chief)

· Grand Chief Doug Kelly (Chair of the First Nations Health Council)
Afternoon SessionPartnership with BC First Nations to Improve Health and Wellness Outcomes

· Honourable John Rustad (Minister of Aboriginal Relations and Reconciliation)

Leadership Dialogue on the Social Determinants of Health Strategy
DECEMBER 1ST – DAY TWO
TIMEAGENDA ITEM
7:30-8:30 amBreakfast
Morning SessionKeynote Presentation on Children and Family Services

· Terry Cross (Founder of the National Indian Child Welfare Association)

Report Back from Regional Caucus

· Ministry of Children and Family Development
Afternoon SessionReport Back from Regional Caucus

· Ministries of Justice and Public Safety

· Ministries of Education and Advanced Education
DECEMBER 2ND – DAY THREE
TIMEAGENDA ITEM
7:30-8:30 amBreakfast
8:30-10:00 amRegional Caucuses
Morning SessionRegional Reflections and Report on Forum

· Speakers Selected by Each Region
Community Engagement and Communications: Implementing the Engagement and Approval Pathway  

· First Nations Health Council
12:00 pmAdjourn


Guest Keynote: Terry Cross,
Founder – National Indian Child Welfare Association

terry-cross

Terry Cross (Ha-ne-ga-noh), an enrolled member of the Seneca Nation, received his master’s degree in social work from Portland State University in Portland, Oregon. He is the founding executive director of National Indian Child Welfare Association, now serving as senior advisor. He is the author of Positive Indian Parenting and co-authored Towards a Culturally Competent System of Care, published by Georgetown University. He has 40 years of experience in child welfare, including 10 years direct practice.

WHO IS INVITED?

The FNHC acknowledges that the social determinants of health are broad and each First Nation organizes its staffing and technical supports according to their own needs and aspirations. The FNHC has asked that the Chief identify two representatives from their community to attend the forum – typically one political lead and one technical lead. As per past practice, the FNHC will cover the costs of two representatives per community as identified by the Chief to attend the forum.

Due to the nature of this year’s Forum, attendance is limited to the above affiliations.

REGISTRATION

For Chiefs to Register: visit https://www.regonline.ca/gatheringwisdomVIII (access code: GWVIII *Chief/proxy only*). All BC Chiefs have received invitation emails and personal phone calls from the event organizers.

For 2nd Representatives to Register: an invitation will be sent to the person identified within the Chief’s online registration process.

 (3) Draw prizes are available to everyone registered by the following deadlines:

Prizes will be gifted to the winners at onsite registration check-in, November 29th or 30th.

  • Friday, November 4th at 5:00pm
  • Thursday, November 10th at 5:00pm
  • Friday, November 18th at 5:00pm

Final deadline to attend the Forum: Friday, November 18th at 5:00pm. Registration is closed after this date.

HOTEL ROOMS

Reservations: Hotel reservation details can be found on the ‘Lodging’ page of the online registration process. If you are already registered but haven’t booked your hotel room, please contact gatheringwisdom@pacegroup.com for details.

Hotel deadline: Wednesday, November 16th at 5:00pm (group rates and availability are not guaranteed after this date).

CONTACT INFO

Email: GatheringWisdom@pacegroup.com

Phone: 604.646.3586

Download this communique in PDF format here (210 KB)

Gathering Wisdom for a Shared Journey VIII

Date:

Communique

Gathering Wisdom for a Shared Journey VIII will be hosted November 30 to December 2, 2016 at the Sheraton Wall Centre Hotel in Vancouver. Since its inception, Gathering Wisdom has been fundamental to shaping a strong and collective vision for First Nation health governance in BC.
The Tripartite Framework Agreement on First Nations Health Governance outlines a meeting at least once every 18 months between the FNHC and representatives of BC First Nations to discuss the implementation of the agreement and the operation of the new Health Governance Structure. The agreement also calls for a governance partnership meeting between the tripartite partners to discuss implementation and overall functioning of the new relationship.

First Nations have been clear that the Gathering Wisdom forum is an important part of the health governance process in BC and that provincial forums must be planned in a way that makes best use of available resources.

 

Learning from the Past and Planning for the Future

At each stage of our shared journey, the Gathering Wisdom forum has evolved. It has been used as a forum for community care providers, a forum for decision-making, and a health conference. This year, Gathering Wisdom will continue its evolution as First Nation leaders gather to discuss the social determinants of health. It will be a smaller-scale event with a specific focus on health and social governance.
 

 
The theme of the forum this year is “Learning from the Past and Planning for the Future”. This theme reflects our traditions as strong, healthy and self-determining Nations. At the same time, it is an opportunity to reflect on our shared journey in health over the past ten years. It is an opportunity to draw upon our strengths as Nations and to chart the course for the next stage of our shared journey. Most importantly, it is an opportunity for First Nations leadership to inform and shape the strategic direction of BC Ministries.

The Gathering Wisdom forum will feature:

  • Dr. Perry Kendall and Dr. Evan Adams – A Report on Progress
  • First Nations Health Council – Developing the Ten-Year Social Determinants Strategy
  • BC Ministries – Ministry Priorities to Support Health and Wellbeing
  • John Rustad, Minister of Aboriginal Relations and Reconciliation
  • Keynote Speaker on Child and Family Wellness

This forum will mark an important step as we begin to build consensus on a vision and long-term strategy for addressing the social determinants of health.

 

Who is invited? Gathering Wisdom VIII and Respecting Directive 6

The FNHC acknowledges that the social determinants of health are broad and each First Nation organizes its staffing and technical supports according to their own needs and aspirations. As such, the FNHC has sent individual invitations directly to each Chief with a registration code for the event. The FNHC has asked that the Chief identify two representatives from their community to attend the forum – typically one political lead and one technical lead. As per past practice, the FNHC will cover the costs of two representatives per community as identified by the Chief to attend the forum.


What are the outcomes? An Action Plan

At Gathering Wisdom, the FNHC and Government of BC will report back to Chiefs on what we heard at Regional Caucuses, including initial priorities and potential action items related to children and family wellness, justice, public safety and education. BC Chiefs will consider strategies to improve systems and set priority areas for action on the social determinants of health in BC.

Based on the priorities and action items identified by Chiefs at Gathering Wisdom, BC Ministers will direct Ministries to include any agreed upon priorities in Ministry Service Plans starting in 2017-18 and set strategic direction for the next 18 months.

For more information on Gathering Wisdom for a Shared Journey or the work underway within the Social Determinants of Health, please visit: www.fnhc.ca or www.gathering-wisdom.ca.

 

A Health Service Focused Conference: Best of Both Worlds

At the recent First Nations Health Directors Association (FNHDA) Annual General Meeting, the First Nations Health Authority (FNHA) announced partial sponsorship for all registered members of the FNHDA to attend the 2017 BC Quality Forum on March 1-3 in Vancouver, BC. The FNHA confirmed the importance of a regular “service-focused conference” delivered in partnership with provincial health system.  The FNHA will be providing more details about this opportunity through the FNHDA in the coming weeks. To learn more please visit: http://qualityforum.ca/pre-forum-sessions/best-of-both-worlds/

 

How do I register?

Each Chief or Chief Councilor in BC received an invitation with a registration code and instructions. Please note that this registration code is required to register the two representatives from each community that will be attending the Gathering Wisdom forum. If you require the registration code or assistance with the process, please contact Pace Group at gatheringwisdom@pacegroup.com or call 604-646-3586.

The event organizers will be contacting communities directly within the next week to assist with the registration process.

 

Please register for Gathering Wisdom before Friday, November 4, 2016 at 5:00 pm to guarantee a hotel room at the venue. New registrations will be accepted until November 18 at 5:00pm.

On World Environmental Health Day, let’s talk about second-hand smoke in First Nations communities

Date:

FNHC-2016-Year-In-Review-4

By Doug Kelly, FNHC Chair

First Nations communities rarely agree on anything. But one thing we do agree on is that we want good health for ourselves, our loved ones, and our land.  And we know that these are all inextricably interconnected. As a First Nations leader, I’d like to share some thoughts on this day, World Environmental Health Day, about what leadership and community members can do to improve our health, the health of our loved ones, and the health of our communities and environments.

Although there are many important areas to tackle, I’ll stick to just one in this message: how we can mitigate the harmful effects of smoking (including vaping) and second-hand smoke in our communities. The facts are scary. Even one cigarette butt in a liter of water can kill a fish in a period of 96 hours. Over 4,000 chemicals are introduced to the immediate environment from discarded butts via cigarette tar and mainstream smoke, posing a direct threat and sometimes death to fish and other marine life as well as birds. Improperly discarded cigarettes are responsible for devastating forest fires every year, including in BC. Cigarette butts are not biodegradable, and they can take up to 10 years to disintegrate. Approximately one tree is destroyed for every 300 cigarettes made.  And so on.

Provincial laws don’t apply on reserve – and of course, nor should they – so it’s up to us as leaders and community members to take action. So what can we do, exactly? Well, to begin with, our elected band councils have the legal authority to pass bylaws on our reserves that protect the health of community members. First Nations leadership can ensure enforcement of provincial laws such as the Tobacco and Vapour Control Act, which limits sales to adults aged 19 and above, restricts retail displays targeting youth, and more.

Leadership can also impose taxes on tobacco products. Since 1998, First Nations communities have had the power to enact bylaws imposing our own sales tax on reserves for fuel, tobacco products and alcoholic beverages. Over 100 studies in the US have concluded that this is one of the most effective ways to decrease smoking rates in any community. Tsleil Waututh and at least 20 other First Nations communities in BC are doing this. They are using the added revenue from the taxes to fund programs, initiatives and projects in their communities such as building a new health centre, offering health education, providing rebates to community members, or funding arts and culture. In Tsleil Waututh, one must have status to be able to purchase commercial or traditional tobacco, and there is also a maximum amount of tobacco that each individual can purchase per month.

Another thing First Nations leadership can do is get involved with educational campaigns that inform First Nations people about the dangers of smoking and second-hand smoke, not just to themselves and others but to their environments. In the Fraser Salish region, for example, we have made improving environmental health a priority and are creating an educational campaign that will address the effects of throwing cigarette butts anywhere instead of disposing of them properly. This campaign is intended to help First Nations smokers learn more not only about the poisonous substances in the cigarettes they are smoking, but about what discarded butts are doing to the people around them, the environment, animals and plants.

Because we all care about our health and the health of our environment, I think we can all agree that smoking is something we need to think about very seriously. Our communities are facing enough problems from external factors and historical factors — let’s agree to try and keep out or reduce what we allow in our communities, including harmful habits like smoking. Let’s commit to loving ourselves, our communities and our environment enough to eliminate smoking from our lives.

 

Fall 2016 Communique

Date:

FNHC-FALL-2016

First Nations in BC share a vision of healthy, self-determining and vibrant First Nation children, families and communities. We as BC First Nations have set a goal of eliminating health inequalities. In addition to improving health services, we want to work collaboratively to address the social and environmental factors that contribute to poorer health outcomes for our people. Through Regional Caucuses and Gathering Wisdom for a Shared Journey, First Nations Chiefs in BC have directed the First Nations Health Council (FNHC) to build partnerships and make progress on the social determinants of health.

Building on the work in health, the FNHC is beginning a dialogue with BC First Nations on ways to increase First Nations decision-making roles and capacity as it relates to health and social services. The FNHC is using the Engagement and Approvals Pathway to build consensus on a ten-year strategy for supporting First Nations children, families and communities in BC.

This fall, First Nations leaders in BC will contribute to a rich dialogue on the social determinants of health. For the first time, the Regional Caucuses will be attended by the Deputy Ministers responsible for child and family services, education, post-secondary education, justice and public safety. These Ministries have agreed to attend the Regional Caucuses to listen to and learn from First Nations leaders. The Ministries are seeking the direction of First Nations leaders as they shape their Ministry service plans and budgets for the year ahead. This is a significant opportunity for BC First Nations and the Government of BC to build stronger relationships and reach an understanding of what can be done differently.

At the end of the Regional Caucus sessions, we invite First Nations leaders to attend Gathering Wisdom for a Shared Journey VIII in Vancouver on November 30th-December 2nd. At the Gathering Wisdom forum, the FNHC and the Government of BC will report back to First Nations leaders on what was heard during the Regional Caucuses. This will be a time for First Nations leaders to review the outcomes of the Regional Caucuses and discuss areas of common agreement amongst BC First Nations. This dialogue will inform the work we do as BC First Nations to build a ten-year strategy to address the social determinants of health.

Read more in the FNHC Fall 2016 Communique here

Highlights include:

Report from the Chair

Upcoming Fall Regional Caucuses – Save the Date!

Gathering Wisdom for a Shared Journey VIII

Working With Other First Nations Organizations

Memorandum of Understanding on the Social Determinants of Health

Memorandum of Understanding on the Social Determinants of Health

Date:

Dear Respected BC First Nation Chiefs and Leaders,

On behalf of the First Nations Health Council (FNHC), we are pleased to provide you with a copy of the Memorandum of Understanding (MOU) signed by the FNHC and the Minister for Aboriginal Relations and Reconciliation (MARR) on March 3rd, 2016.

Adding to the rich history and spirit of partnership with the Government of British Columbia (BC), this MOU sets out a pathway to partnership on the social determinants of health. This document embodies the shared commitment of the FNHC and the Government of BC to take the next step in our shared journey. We agreed to work jointly  with BC First Nations to develop approaches that will address the social determinants of health.

When BC First Nations completed the transfer of federal health programs and funding to First Nations control in October 2013, the FNHC fulfilled a key commitment. At the beginning of 2014, the FNHC started a dialogue with First Nation leaders to determine how we would fulfill other commitments in the FNHC mandate. Over the past two years, we shared perspectives and we listened and learned from one another.

During the last round of Regional Caucuses, Chiefs and Leaders considered priority areas for addressing the social determinants and supporting healthy child and family development. This MOU with the Government of BC is a direct reflection of those discussions. It is a starting point, not the destination. It is a shared commitment of the FNHC and the Government of BC to support an ongoing and regular process of engagement with BC First Nations that results in significant and culturally appropriate actions to address the social determinants of health.

As the FNHC take steps to implement this MOU with BC First Nations and the Government of BC, it is important to provide Chiefs with an overview of its contents. A copy of the MOU has been enclosed for your convenience.

The MOU with the Government of BC represents two significant steps forward. First, it reaffirms a shared commitment to work from a holistic perspective. It is an acknowledgement that coordinated and concerted action is required to address the related and underlying circumstances that determine individual and collective wellbeing. This encompasses the dimensions of physical and mental wellbeing, family income and food security, early learning and education, child safety, and connectedness to family, community, culture and language. Second, it serves as a shared commitment to support BC First Nations in building consensus, setting priorities and taking a staged approach to implementation. The social determinants of health are complex and require dialogue to set strategic direction for each area.

There will be many familiar elements to this MOU. At its core, this MOU represents a shared commitment of the FNHC and the Government of BC to support a process that is Community-Driven and Nation-Based. It serves as a shared commitment to use the Engagement and Approval Pathway endorsed by BC First Nations at Gathering Wisdom for a Shared Journey V as the process to engage BC First Nations at regional and provincial levels.

In the short-term, the MOU sets out a process of engagement, planning and priority setting. It means the FNHC will engage Chiefs at Regional Caucuses in spring and summer 2016 leading up to the Gathering Wisdom for a Shared Journey forum in fall 2016. Through this initial phase of engagement and planning, the FNHC envisions that First Nations will be able to set initial regional priorities related to the social determinants with a strong focus on supporting First Nation children, youth and families.

For its part, the Government of BC has made a commitment to review the initial regional priorities identified by BC First Nations with the FNHC. The BC Ministers and FNHC will develop a list of priority actions for discussion and feedback by Chiefs. At the Gathering Wisdom for a Shared Journey forum, Chiefs will review, discuss and give feedback on these priority action items. The feedback provided will inform the Ministers and Deputy Ministers as they prepare respective Ministry service plans for the 2017-18 Fiscal Year. This is an important first step and represents a fundamentally new way of working with the Government of BC on issues of collective importance.

While this work proceeds, the FNHC and Government of BC will redouble our efforts to bring the Government of Canada to the table. We acknowledge that the Government of BC is only one part of the picture and that the Government of Canada must be a full partner in this process. To this end, the MOU serves as a shared commitment to work jointly with BC First Nations and the Government of Canada in the design and development of a tripartite ten-year social determinants strategy that more fully describes actions to be taken to address the social determinants of health. We understand that the tripartite ten-year strategy will take time to develop and can only be developed once the FNHC engages Chiefs.

While these are important steps, the FNHC and Government of BC acknowledge that this is only a starting point. The constellations of lived realities that comprise the social determinants of health are complex and require many hands to do this work. In the coming weeks, the FNHC will sit down with Deputy Ministers for the Government of BC to discuss our approach over the next six months. In the months ahead, the FNHC will engage directly with Chiefs at Sub-Regional Caucuses, Nation Assemblies and Regional Caucuses. Through this dialogue, we will seek your guidance and leadership to design a strategic approach with clear milestones to guide the work.

We look forward to meeting with you soon.

In wellness,

Grand Chief Doug Kelly

Chair

Warner Adam

Deputy Chair

Read this letter in PDF format here

Read the Memorandum Of Understanding in PDF format here

Read the FAQ for the Memorandum of Understanding here

FNHC Speaks to Auditor General Report

Date:

Dear Respected BC First Nations Chiefs and Leaders,

As duly appointed representatives to the First Nations Health Council (FNHC), we write to share information in response to recent questions and concerns. First, we wish to thank the Chiefs and Leaders that shared words of encouragement and appreciation for the work of the First Nations Health Authority (FNHA). The Office of the Auditor General (OAG) report and the subsequent media storm caused the FNHA Board, Senior Staff, and Caregivers significant stress. Your words of support meant so much. Thank you.

On February 2nd, the Office of the Auditor General of Canada (OAG) published a study on the FNHA. On that same day, an anonymous and redacted document was published online. This document contained serious allegations about the FNHA and the First Nations men and women leading the FNHA. It is important to be clear that the study conducted by the OAG and the anonymous document released by the media are separate and the contents of these should not be confused with each other.

As health and wellness leaders, the FNHC seeks to end all forms of lateral violence. We are committed to act with lateral kindness. We acknowledge that the anonymous document and the subsequent media coverage have clouded the OAG report and its conclusions. We acknowledge that this type of media coverage can be unsettling and that Chiefs and Leaders have questions. We urge Chiefs and Leaders to read the OAG report itself and to not confuse the recommendations of the OAG with the extreme and negative narrative painted by the media.

To assist you, the FNHA Board has attached a summary of the OAG report for your convenience. As we prepare for our Regional Caucus meetings this year, we ask you to review the report, consider its contents, and ask us questions.

The study completed by the OAG study was composed of two parts. The first part of the study looked at how BC First Nations worked together to establish the first-of-its-kind FNHA. The second part of the study looked at the corporate policies of the FNHA. The anonymous document was not the primary subject of the OAG’s study. While the OAG reviewed FNHA policy in light of the anonymous document, the OAG did not investigate these allegations.

We would like to highlight the following from the report:

  • The OAG did not audit the merit of the allegations contained in the anonymous document. The OAG reviewed FNHA policies and the application of those policies in relation to these allegations.
  • The OAG concluded that the FNHA was taking steps to strengthen accountability and governance by revising key policies and procedures and providing added guidance to staff to ensure consistent application of corporate policy.
  • The OAG concluded that the decision of the FNHA to pursue accreditation will serve to strengthen corporate policy as this process requires voluntary third party verification.
    Health Canada confirmed that the FNHA has fulfilled all of its obligations as set out in the Framework Agreement (2011) and the Canada Funding Agreement (2013).

Health Canada’s official response to the report confirms that “the FNHA has been diligent in providing Health Canada with quality and timely deliverables against all its obligations and meeting the accountability and governance requirements set out in the framework agreement.” In addition to providing Regional Caucuses with our annual reports and audit statements, the members are confident the FNHA is meeting its accountability obligations to our governance partner and funder.

When we started this journey ten years ago, we agreed to complete health transfer only if we did a better job. Along the way, we faced challenges and tough conversations. We agreed that we are stronger together and worked to resolve those challenges. BC First Nations established governance standards and structures to ensure oversight, high operational performance and the separation of operations and politics. Our shared vision, values and standards for good governance have been key to our collective success and will continue to be the center of this work.

As leaders we witnessed the FNHA overcome many challenges as it navigated through transfer and built a new First Nations organization from the ground up. The FNHA has publicly committed to the highest standards of excellence in serving our communities. The FNHA has acknowledged that there are areas for improvement and, as a learning organization, has committed to listen, learn and act. As members we will do what we have always done, and look to our First Nations leadership for wisdom and guidance in finding ways to strengthen our health governance structure. In closing, we recruited the FNHA Board of Directors based upon their competencies, skills, and expertise. The FNHA Board of Directors, the CEO, and the Senior Management Team continue to have our full confidence and support as we make the necessary changes and improve upon our processes to deliver the highest quality services for First Nations peoples in BC.

In wellness,

Members of the First Nations Health Council

 

Click here to read and download the full summary document

First Nations and Accountability – A Colonial Narrative of Convenience

Date:

Shane Gottfriedson, British Columbia Assembly of First Nations Regional Chief

(From our BC AFN Partner Shane Gottfriedson)

Let’s be clear, everyone needs to be accountable and responsible for their actions. The principle of Reciprocal Accountability has been a foundation in many First Nations communities since time immemorial. The tale of First Nations’ irresponsibility, lack of accountability and inability to manage our own affairs is founded in the ignorant and discriminatory views of First Nations peoples by some Canadians.
 
The Office of the Auditor General (OAG) issued a report this week. The report analyzes the success factors that enabled BC First Nations to be the first in Canada to assume control over health care. The report also recommends ways that the FNHA can strengthen its corporate governance. Importantly the report endorses the B.C. Tripartite health transfer process as a sound approach to overcoming the structural impediments which result in poorer health outcomes for First Nations.
 
We are emerging from a fearful place right now in this country. Ten years of a Harper government in Canada has resulted in an environment characterized by mistrust, blame and condemnation. Achieving health transfer during this period was challenging. There was a lot of static about First Nations and transparency, a lot of fear about First Nations in the driver’s seat. Our people chose this, our leadership voted for this and entrusted the FNHA with this work and the FNHA is accountable to us.
 
The recent human rights ruling on child welfare amplified awareness of the cost of a two-tiered system. The health gap that First Nations continue to experience is unacceptable and increasing First Nations decision-making in health is confirmed as the best way to address this. Over the past 30 years Canada’s own Indigenous Health Policy has been incrementally shifting to accommodate this common-sense approach.
 
This narrative promotes doubt in First Nations’ capacity for self-determination over our children, families and communities. Many First Nations are still wondering who holds the accountability for colonization, the damage of Residential Schools and outdated policies that affect our lives by alienating us from our lands and resources.
 
The Tripartite Health Transfer process in B.C. has been declared a best practice and a sensible path forward for better health services for First Nations people by the United Nations, respected clinicians, educators and governance partners, and our media partners regionally, nationally and internationally. This is a critical point that should not be lost among the colonial noise of First Nations perceived irresponsibility.
 
The foundation of the First Nations Health Governance Structure is strong and was built over the last 20-plus years by Chiefs and leaders across B.C. including some of the most respected names in BC First Nations communities such as Grand Chief Stewart Phillip, the Honourable Jody Wilson-Raybould, Kukpi7 Wayne Christian, Wickaninnish Cliff Atleo Sr., former National Chief Shawn Atleo, Grand Chief Ed John and Grand Chief Doug Kelly. Federal and provincial supporters have included former Prime Minister Paul Martin, BC Premier Gordon Campbell and dozens of Ministers of Health from both governments including the Honourable Jane Philpott and the Honourable Terry Lake.
 
The First Nations Health Authority stated they welcomed the OAG audit. The OAG set out to share the good work in B.C. with other First Nations and Canadians. The report states that the FNHA is overcoming the service gaps for First Nations Peoples. Health Canada clearly states the FNHA has met its accountability requirements and has consistently provided quality and timely deliverables. The OAG audit confirms that the FNHA established an accountability and governance framework to guide operations and promote transparency and accountability, and that they are on the right path to strengthening policy in this area.
 
FNHA is incorporating First Nations cultural perspectives and approaches, industry best practices and procedures found in other public and private organizations to learn and grow. As a young organization they have committed to creating the best First Nations Health Governance Structure in the world. We all have an accountability to hold – if there are concerns, let’s hear them, address them and move forward.
 
We are making history in B.C. and it’s not always going to be easy but this work will always be worth it. The narrative of First Nations unable to manage their own affairs is a tired one we have heard for too many years. Our relationship with Canada is strong. We believe that with our new partners we can achieve great things. The Right Honourable Justin Trudeau and his team offered the opportunity for a new relationship founded on respect and we accepted his offer.
 
We recognize we are blazing a trail in our communities, in the Province of B.C., Canada and around the globe in creating the first First Nations Health Authority – something First Nations and all Canadians should be proud of. Our people are hopeful. We are hopeful. We will continue to guide the work in B.C. with the highest standards of accountability and transparency.
 
Shane Gottfriedson is the British Columbia Assembly of First Nations Regional Chief