Gathering Wisdom, Now What? A Tripartite Presentation BC Tripartite - - PowerPoint PPT Presentation

Gathering Wisdom, Now What? A Tripartite Presentation

BC Tripartite First Nation Health Governance Framework Agreement UBC Learning Circle

September 29, 2011

Presented by: Grand Chief Doug Kelly, Ian Potter, and Arlene Paton

Gathering Wisdom IV

• Unprecedented First Nations leadership

support for: – New health governance structure – Transfer of Health Canada – B.C. FNIH responsibilities to a new First Nations Health Authority – Align to seven directives – Report back May 2012

Consensus: 7 Directives

• Directives describe fundamental standards

and instructions for new health governance arrangement

Consensus: 7 Directives

Directive #1: Community- Driven, Nation- Based Directive #2: Increase First Nations Decision- Making and Control Directive #3: Improve Services Directive #4: Foster Meaningful Collaboration and Partnership

Consensus: 7 Directives

Directive #5: Develop Human and Economic Capacity Directive #6: Be Without Prejudice to First Nations Interests Directive #7: Function at a High Operational Standard

Regional Caucuses in each Health Region will establish Regional Tables to:

• Engage with First Nations
• Develop and implement arrangements

between Regional Tables and Regional Health Authorities

• Develop regional perspectives and

approaches to health and wellness

• Effective, efficient and sustainable

engagement and operations

Consensus:

Role of Regional Caucuses/Tables

PRIORITIES Engagement with First Nations Effective delivery of services including address service gaps and innovation Improve NIHB program Implement First Nations values Health literacy and self-care Health partnership with Province including shared service opportunities Capital, infrastructure, equipment Health human resource development Cultural competency training First Nations Deputy PHO Constituted with good governance, accountability, transparency and defined

• perating standards and governed by a Board of Directors with experience in

First Nations health programs and services and successfully running a large

• peration.

Consensus:

Role of First Nations Health Authority

Work plan to deliver on Resolution

• As directed by leadership at Gathering

Wisdom IV, a work plan developed for review by regional caucuses.

• Work plan details key deliverables set out

in resolution 2011-01.

• Work plan to be reviewed by regional

caucuses this fall.

First Nations Health Governance Structure Workbook

• Final FNHA form/structure to be

developed via further research, analysis, and engagement with First Nations, as led by the FNHC (2012)

• Permanent structure workbook process

rolled out via regional caucuses (early 2012)

• First Nations to vote on permanent

structure at Gathering Wisdom V (May

2010)

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What does the Framework Agreement do?

• Establishes a new governance structure

for First Nations health – First Nations fully involved in planning, programming and delivery – A First Nations Health Authority – First Nations take over Federal Regional role – Federal and Provincial commitment to funding

Federal Commitments in Framework Agreement

• Transfer all resources to support programs

to the FNHA

• Ten year block funding agreement
• Implementation funding
• Participation by Canada in committees in

support of its role as governance partner

• BC First Nations invited to Federal “Health

Determinants” Tables

Why is the Framework Agreement Important?

• First Nations involved in all aspects
• f their health services
• Provides First Nations with

governance and administrative tools for effective and efficient service

• Creates long term stability

COMPARISON OF CURRENT & PROPOSED ELEMENTS

Elements Current Proposed

Policies & Programs

• Decisions are

made in Ottawa by federal government

• Decisions are made

in BC by BC First Nations Regional Management (for day to day

• perations)
• Accountable to

Ottawa

• Accountable to BC

First Nations

COMPARISON OF CURRENT & PROPOSED ELEMENTS

Elements Current Proposed

Health Services

• Limited to federal

policies

• Little integration

with Provincial health system

• New partnership

with Regional Health Authorities

• Service designed to

meet the needs of First Nations Funding

• Year by year

allocation – uncertainty

• 10 years stable

funding

• Guaranteed annual

growth

• No change to fundamental relationship
• No impact on First Nations rights, treaties or

self government

• Federal role changes to governance partner:

– Collaboration on:

• Social determinants of health
• Sharing research and promising practices
• Program design and policy
• Federal Regional staff transferred to First

Nations Health Authority Evolving Relationship between First Nations and Federal Government

Transition

• Transfer anticipated within two

years of signing the FA

• Mechanisms to support Transfer:

– Canada Funding Agreement – Sub-agreement negotiations to effect the transfer – Implementation Structure – Health Partnership Accord

BC Undertakings

• a commitment to explore various

legislative options to establish legal authority of the FNHA and enable public health functions.

• directing Health Authorities to collaborate

with the FNHA at the regional level to facilitate coordination and integration of First Nations health programs and services.

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BC Undertakings Cont’d

• Develop a Health Partnership Accord to

describe the shared vision.

• Discuss “innovative arrangements for

service delivery” where mutually agreed upon.

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Continued Role of Province and Health Authorities

• Ensure duplication will not occur and a

parallel health service delivery structure will not be created.

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Ongoing Provincial Funding Commitment

• $83.5 Million to the First Nations Health

Society to implement the commitments in the Transformative Change Accord and the Tripartite First Nations Health Plan.

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