FIRST NATIONS HEALTH AUTHORITY UPDATE

Evan Adams, MD, MPHDeputy Provincial Health Officer

Office of the Provincial Health OfficerMinistry of Health

May 1, 2013

Who are Indigenous Peoples?There are an estimated 370 million Indigenous people living in over 70 countries worldwide. They present a rich diversity of cultures, religions, traditions, languages & histories yet they continue to be among the world's poorest & most marginalized populations.

Who are Indigenous Peoples? An official

definition of “Indigenous" has not been adopted by the United Nations system due to the diversity of the world’s Indigenous peoples.

Instead, a modern & inclusive understanding of “Indigenous" has been developed & includes peoples who:

Have strong links to territories & surrounding natural resources.

Maintain distinct languages, cultures & beliefs.

Have distinct social, economic or political

systems.

Resolve to maintain & reproduce their ancestral environments & systems as distinctive peoples & communities.

Form non-dominant groups of society.

The Report of the Royal Commission on Aboriginal Peoples (1996)

concluded:

“Aboriginal people are at the bottom of almost every available index of socioeconomic well-being, whether [they] are measuring educational levels, employment opportunities, housing conditions, per capita incomes or any of the other conditions that give non-Aboriginal Canadians one of the highest standards of living in the world.”

CONTEXT- Agreements

• Leadership Accord (2005)

• The New Relationship (2005)

• The Transformative Change Accord (2005)One of the purposes of the TCA is to bring together the three parties to

achieve goals of closing the social & economic gap between First Nations and other British Columbians over the next

10 years.

Tripartite First Nations Health Plan

• Signed June, 2007, by the Tripartite partners to build on the bilateral Transformative Change Accord: First Nations Health Plan.

• Commits the partners to take action in:– Governance, Relationships &

Accountability– Health Actions – Health

Services, Health Promotion & Disease & Injury Prevention, & Performance Tracking

– Implementation, Oversight & Community Engagement

Tripartite First Nations Health Plan

Governance Health Actions

One Plan

Governance is a Key ElementOutcomes of Governance Work:

o Effective & accountable First Nations, in full partnership with BC & Canada

o Culturally-responsive systemo Efficient & sustained delivery

structure (no duplication)o First Nations health care

needs & priorities meto Better First Nations health

outcomes

7 HEALTH ACTION TRIPARTITE STRATEGY TABLES (TST)

(First Nations + Province + Federal decision-makers)

Planning Group (s)

TECHNICAL COMMITTEE/

WORKING GROUP – SUBJECT A

TECHNICAL COMMITTEE /

WORKING GROUP – SUBJECT B

Implementation – Provincial, regional, &/or local

Planning level – Provincial / Regional

Strategic level – Provincial overview

Health Actions “Model”

Tripartite Management

Team

Primary Care & Public Health

Mental Health &

Addictions

Maternal & Child Health

Health Human

ResourceseHealth

Health Planning &

Capital

Health Knowledge

& Information

Health Actions Strategy Areas

Emergency Planning - Themes

* Emergency Response to Natural Disasters in First Nations Communities: Roles and Responsibilities (First Nations & Inuit Health, Health Canada)* First Nations Health Emergency Management Working Group - Understand & respect First Nations - Collaboration to clarify complex web or organizational roles - Increase linkages to the FNHA - Flow charts & algorithms w/ contacts please

Framework AgreementFederal Undertakings• Section 6.3(1)

Canada shall... provide funding to the FNHA to support the transfer of Federal Health Programs… in phases or blocks as agreed… within two years of signing.

Framework Agreement – Key Elements

• A new Health Governance Structure where First Nations plan, manage, design & deliver certain health programs & services

• A more integrated Health System with stronger linkages between service providers & reflective of BC First Nations cultures & perspectives

• Facilitates discussion of the determinants of health

• Provision of health care access at minimum comparable to those in similar locations

• Reciprocal accountability

First Nations Undertakings

• Support a regional structure which allows First Nations to collaborate among themselves to plan, design, deliver & manage a range of health services to First Nations people in BC

• Establish working relationships & reciprocal accountability processes with Health Canada, BC Ministry of Health, regional Health Authorities & other providers

• Work with partners to integrate First Nations models of wellness.

• Develop Health information systems & protocols for information sharing/surveillance

• Work with broad partners to address social determinants

Also• We have been concluding Sub-Agreements

to describe how the transfer of First Nations & Inuit Health Branch (FNIHB)-BC Region (Health Canada) to the First Nations Health Authority will take place – by October 1, 2013.

• We have been working in our regions to conclude arrangements & partnerships with regional Health Authorities.

Our Healthy Communities

Coming together

to address issues

High quality

education for our children

& families

Proper Housing

Prosperity &

Wealth

Strong culture

& Tradition

s

Evidence of

healthy activitie

s & sport

Valuing our

lands & territorie

s

discussion