Tripartite First Nations Health Plan
May 23, 2007
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Introduction
Purpose
Vision
Principles
Governance, Relationships and Accountability
Health Promotion/Disease and Injury Prevention
Health Services
Performance Tracking
Implementation, Planning, Oversight, and Community
Engagement
Funding
Term of Plan
Introduction
On November 27, 2006, the British Columbia First Nations Leadership
Council (FNLC) and the Province of British Columbia negotiated
the ten-year Transformative Change Accord: First Nations Health
Plan (TCA: FNHP), (attached as Appendix 'A'), which identifies
twenty-nine actions intended to close the gaps in health status
between First Nations people and other British Columbians. The
TCA: FNHP was inspired by the First Nations Health Blueprint
for British Columbia, published by the FNLC in July 2005,
and the 2001 Report of the Provincial Medical Health Officer, The
Health and Well-being of Aboriginal People in British Columbia.
Also, on November 27, 2006, the FNLC, the Government of Canada,
and the Province of British Columbia signed a First Nations
Health Plan Memorandum of Understanding (attached as Appendix 'B'). This MOU commits the Parties to the development of a tripartite
First Nations Health Plan by May 27, 2007, using the Transformative
Change Accord: First Nations Health Plan as a framework.
Purpose
To build on the First Nations Health Plan Memorandum of Understanding and
the TCA: FNHP through the development of a 10-year Tripartite First
Nations Health Plan ('Plan') that:
- Creates fundamental change for the improvement of the health
status of First Nations people in British Columbia;
- Defines a series of founding principles that will underpin
the development and implementation of a new governance system
for health services and guide systemic changes; and
- Establishes goals for the successful implementation of short
and medium-term actions related to the implementation of the
Plan.
This Plan is an enabling document that allows the federal, provincial,
and First Nations partners to explore, develop, test, and implement
new priorities, structures, and processes over time. Most importantly,
this Plan supports the development of local health plans for all
BC First Nations and recognizes the fundamental importance of community
solutions and approaches.![Top of page](/web/20071126105329im_/http://www.hc-sc.gc.ca/images/fnih-spni/arrow_up.gif)
Vision
It is the collective vision of the Province of British Columbia,
the Government of Canada as represented by the Department of Health
("Health Canada") and the First Nations Leadership Council
that the health and well-being of First Nations is improved, the
gaps in health between First Nations people and other British Columbians
are closed, and First Nations are fully involved in decision-making
regarding the health of their peoples.
Components of this vision include:
- Each First Nation and mandated health organization [A health
organization or agency with a defined mandate that is created
and ratified through Band Council Resolutions or a motion passed
at a duly convened meeting of representatives of the Chiefs and
Councils and authorized for that purpose. Usually, but not always,
such a mandated organization or agency will be legally incorporated.] will have a comprehensive
health plan that will be a foundational document for the design of community health services
and the creation of working partnerships with governments and health
service providers.
- First Nations health services will be delivered in a manner
that effectively meets the needs, priorities and interests of
First Nations communities and First Nations individuals, regardless
of their residency, and recognizes the fundamental importance
of community solutions and approaches.
- First Nations individuals in all regions of British Columbia
will have access to quality health services comparable to those
available to other Canadians living in similar geographic locations.
- First Nations and their mandated health organizations will
be central to the design and delivery of all health services
at the community level. These health services will be coordinated
with other community-based services.
- Health services delivered by First Nations, when appropriate,
will be effectively linked to and coordinated with provincially-funded
services, such as those provided by the regional health authorities.
- First Nations health services will be delivered through a new
governance structure that leads to improved accountability and
control of First Nations health services by First Nations.
- Health Canada, in cooperation with the First Nations Leadership
Council and the Province of British Columbia, will continue to
evolve its role from that of a designer and deliverer of
First Nations health services to that of funder and governance
partner, based on priorities set in the annual workplan
and the ongoing assessment of progress. Federal and provincial
support for First Nations delivered services will be provided
through more flexible funding mechanisms with streamlined reporting
requirements and accountability measures.
- First Nations, Health Canada and the provincial government
(including its regional health authorities) will maintain an
ongoing collaborative relationship based on respect, reconciliation,
and recognition of each other's roles as governance partners.
![Top of page](/web/20071126105329im_/http://www.hc-sc.gc.ca/images/fnih-spni/arrow_up.gif)
Principles
The implementation of this Plan, including the creation of a new
governance structure for First Nations health services, will be
based on the following principles:
Respect and Recognition:
- The Parties acknowledge and respect established and evolving
jurisdictional and fiduciary relationships and responsibilities,
and will seek to remove impediments to progress by establishing
effective working relationships.
- Cultural knowledge and traditional health practices and medicines
will be respected as integral to the well being of First Nations.
- Health services will reflect the diversity, interests and vision
of First Nations for the delivery of health and other community
services and lead to improved health status for individuals,
families and communities.
- The coordination of federally and provincially-funded health
programs and services will be more effective and include the
increased participation of First Nations in the governance, management
and delivery of services.
Commitment to Action:
- Health and wellness for First Nations encompasses the physical,
spiritual, mental, economic, emotional, environmental, social
and cultural wellness of the individual, family and community.
Although the present Plan focuses on health programs and services,
it is recognized that the way forward will require a joint commitment
to deal with the root causes and structural issues causing socio-economic
gaps.
- All Parties to this Plan will contribute financially and/or
in kind to the implementation of the new First Nations health
service governance and delivery structures and other elements
of the Plan, based on mandates, available resources and authorities.
- Duplication will not occur and a parallel health service delivery
structure will not be created.
Nurture the Relationship:
- The actions of the Parties will be based on reciprocal
accountability; each Party will be responsible to the
others for obligations and commitments under this Plan. The
Parties respect the need for, and commit to, the evaluation
of progress and initiatives.
- The capacity development requirements of the First Nations
health sector will be paramount, through planned growth, knowledge
and skill transfer. Federal and provincial service delivery infrastructure
will not be expanded or enhanced without consideration of viable
First Nations alternatives.
Transparency:
- The Parties will discuss potential changes to programs and
services (including the transfer of programs and services) that
might impact other Parties.
- Information will be shared between the Parties in an open and
timely manner, subject to and in accordance with law.
Governance, Relationships and
Accountability
A new structure for the governance of First Nations health services
in British Columbia, which will initially include regional health
planning and administration as well as health design, delivery
and accountability, will be created and implemented to reflect
the service delivery needs of First Nations and to define results
to be achieved. The new governance structure for First Nations
health services in British Columbia will have four essential components:
A First Nations Health Governing Body will be developed
through the work of a tripartite committee within three years to:
design a new governance structure; seek ratification of this governance
structure by the Parties; and oversee the implementation planning.
The Governing Body will provide for the effective participation
of First Nations in: enacting policies; identifying the results
to be achieved in the delivery of programs; allocating resources;
establishing service standards; implementing ongoing reciprocal
accountability requirements; and other key functions of governance.
In the interim, the Parties will support a process for First Nations
to have greater control over augmented resources dedicated to improve
health services.
A First Nations Health Council, created by BC First Nations,
with the mandate to: serve as the advocacy voice of First Nations
on health-related matters; to support all First Nations in achieving
their health priorities, objectives and initiatives; to participate
in federal and provincial government health policy and planning
processes; and to provide leadership in the implementation of this
Plan.
A tripartite First Nations Health Advisory Committee,
as identified in the TCA:FNHP, will review and monitor the Aboriginal
Health Plans of the regional health authorities, monitor health
outcomes in First Nations communities, and recommend actions to
the Parties on closing health gaps.
An association of health directors and other health professionals will create and implement a comprehensive capacity development
plan for the management and delivery of community-based services
and support First Nations and their mandated health organizations
in training, program development and knowledge transfer.![Top of page](/web/20071126105329im_/http://www.hc-sc.gc.ca/images/fnih-spni/arrow_up.gif)
Health Promotion/Disease and Injury
Prevention
The actions identified in the TCA: FNHP will form the basis of
a tripartite health promotion and disease and injury prevention
strategy. This strategy will be developed and implemented within
the next three years, and will identify joint funding sources,
responsibility for action items, and delivery outcomes.
Health Services
British Columbia is responsible for the provision of health services
to all citizens of the province through its regional health authorities.
Health Canada supports First Nations through a range of public
health programs and benefits intended to improve population health
and ensure effective access to the health care system. The TCA:
FNHP identifies some specific projects and activities intended
to close jurisdictional and health gaps and optimize funding opportunities
for innovations that will make a greater difference in First Nations
communities.
A multi-jurisdictional health planning framework will be developed
that provides service delivery linkages between goals and activities
described in First Nations' community health plans with those of
regional health authority service plans. Service delivery planning
will be ongoing and evolve over time.
Performance Tracking
The First Nations Health Plan Memorandum of Understanding and
the Transformative Change Accord: First Nations Health Plan identify
seven "performance indicators" that will be used to track
progress on closing the gap in health status between First Nations
people and other citizens of British Columbia. Other key indicators
will also be identified as appropriate, including the measurement
of new and improved health governance, management, and service
delivery relationships at all levels.
First Nations, British Columbia, and Health Canada have worked
closely for many years and will continue to work collaboratively
to collect data and report on health outcome indicators. The Parties
will also work jointly to measure progress in key areas on the
advice of the Health Advisory Committee, the First Nations Health
Council, and the association of health directors and other health
professionals.
Implementation, Planning, Oversight, and Community
Engagement
A workplan for this Tripartite First Nations Health Plan will
be developed and updated by the Parties on an annual basis and
a report on progress will be prepared every three years, with recommendations
for improvement. An initial workplan will be developed within six
months of the release of this Plan and will incorporate input from
First Nations provided at the first BC First Nations Health
Forum: Gathering Wisdom for a Shared Journey, held on April
10-11, 2007. The finalization of this workplan will not impede
implementation of key action items in the interim.
High level engagement of all the Parties to the Plan will be managed
through annual Principals' meetings between Ministers of Health
and the First Nations Leadership Council, to review progress.
Engagement with First Nations, their mandated health organizations,
and health care providers on this Plan will be achieved through
regularly scheduled province-wide and regional Forums and a comprehensive
communications strategy.![Top of page](/web/20071126105329im_/http://www.hc-sc.gc.ca/images/fnih-spni/arrow_up.gif)
Funding
The implementation of this Tripartite Plan will be partially funded
through current federal and provincial budget allocations. The
Parties to this Plan acknowledge that additional funding will be
required and agree to explore ways to sustain the implementation
of the Plan through new investment over the term of the Plan.
Term of Plan
The First Nations Tripartite Health Plan covers the period from
June 1, 2007 to May 31, 2017.
Appendices
Some of the following hyperlinks are to sites
of organizations or other entities that are not subject to the Official
Languages Act. The material found there is therefore in the language(s)
used by the sites in question.
Appendix A: The
Transformative Change Accord: First Nations Health Plan
Appendix B: First
Nations Health Plan Memorandum of Understanding (PDF version)
Approved by the Parties on the 27th day
of May, 2007, and signed on the 11th day of June, 2007.
Government of
Canada |
Government of
British Columbia |
Honourable Tony Clement Minister of
Health |
Honourable Gordon Campbell Premier |
Witness |
Witness |
First Nations Leadership Council
The First Nations
Summit |
BC Assembly
of First Nations |
Union of BC
Indian Chiefs |
Grand Chief Edward John |
Regional Chief A-in-chut Shawn Atleo |
Grand Chief Stewart Phillip |
Chief Judith Sayers |
|
Chief Robert Shintah |
Dave Porter |
|
Chief Lynda Price |
|