Blueprint on Aboriginal Health: Approach for a First Nations Specific Framework

1
Blueprint on Aboriginal HealthApproach for a
First Nations Specific Framework

• CSSSPNQL
• June 2005

2
Discussion Points

• FPT Landscape
• National Chiefs Commitments
• Getting Results
• First Nations Health Action Plan
• Follow-Up to FMM
• Federal Investments
• Blueprint
• Engagement of First Nations
• National
• Regional
• National First Nations Blueprint Framework

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F/P/T Landscape in Health

• Council of the Federation
• Restructuring federalism with implications for
  First Nations governments
• Addressing health and other issues within a
  population health approach
• First Ministers Health Accords
• Ten-Year Plan for Canada Focus on Quality,
  Accessibility and Sustainability

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Significance of First Nations for F/P/T Landscape

• First Nations population is larger than that of
  four provinces in Canada
• Historical relationship with Canada
• Treaty and Inherent Rights
• Constitution, section 35
• Fiduciary Duty
• First Nations governments have responsibility in
  a majority of cases for the delivery of health
  services in their communities
• First Nations have the power to exercise
  jurisdiction and by-law making authority in the
  area of maintaining public health and safety

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F/P/T/First Nations Relations

• RCAP and Romanow
• Consolidated and targeted funding for First
  Nations health
• Health Partnership model focus on meaningful and
  ongoing input, and capacity building
• Canada-Aboriginal Peoples Roundtable
• First Ministers Special Meeting on Aboriginal
  Health, Sept. 04
• Cabinet-Aboriginal Leadership Policy Retreat

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Real Engagement

• Governments commitment to transformative change
• underlying social and economic framework that
  perpetuates inequities
• Recognition of First Nations Governments
• Key for May Cabinet Retreat Political Accord
• Treaty Relationship and Inherent Right to
  Self-Government affirm First Nations Jurisdiction
  
• Potential for new collaborative models
  implemented by First Nations authorities with
  targeted and consolidated funding

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Real Engagement (ctd.)

• No longer will we in Ottawa develop policies
  first and discuss them with you later.  This
  principle of collaboration will be the
  cornerstone of our new partnership.
• Prime Minister Paul Martin,
• Canada-Aboriginal Peoples Roundtable,
• April 19, 2004

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National Chiefs Getting Results Strategy

• Recognizing and Implementing First Nations
  Government
• Securing the Place of First Nations in Canada and
  the World
• Strengthening First Nations Communities
• First Nations Health Action Plan

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GRS Policy Development

• Building collaborative relationships with F/P/T
  jurisdictions that move beyond consultation to
  joint policy development
• Key steps
• Engage First Nations leaders
• Host National Dialogues
• Seek Independent First Nations expertise
• Secure government mandate for change
• Undertake joint national policy processes.

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First Nations Health Action PlanSowing the Seeds

• Dec/03, Minister of Health invites AFN to submit
  a proposal re. seat at FPT Advisory Committees on
  Health
• Feb/04, National Chief requests involvement in
  the Council of the Federation
• Apr/04, first Canada-Aboriginal Peoples
  Roundtable
• Minister Pettigrew recognizes the federal
  governments fiduciary obligation in First
  Nations health

• May/04, Premiers Campbell and McGuinty meet with
  AFN
• June/04 Premier Campbell and National Chief
  agreed to seek approval for a joint presentation
  to the Council in July
• Regional Chief Erasmus presents to the Western
  Premiers Meeting, July 2004
• National Chief meetings with Romanow
• National Chief participates at September 13,
  2004, First Ministers Meeting

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First Nations Health Action Plan
First Nations controlled and sustainable health
system that adopts a holistic, culturally
appropriate approach
GETTING RESULTS
Sustainability
Integration
Sustainable Financial Base
Integrated Primary Continuing Care
Health Human Resources
Public Health Infra-structure
Healing and Wellness
Information and Research Capacity
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First Nations Health Action Plan Sustainability

• New Federal Investments up to 182M/year Required
• Cost drivers show an annual potential average
  growth rate of 10-12.
• Key Elements of Sustainability Required
• Funding matched to population growth, health
  needs and cost drivers
• Multiyear funding arrangements for long-term
  planning
• Flexible and consolidated funding
• Adequate funding for core community health
  programming, health human resources (e.g. wage
  parity) administration

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First Nations Health Action Plan Non-Insured
Health Benefits

• First Nations Action Plan on Non-Insured Health
  Benefits for June 2005 Program Renewal
• Estimated 10.9 annual escalator required
• Key Concepts of Renewal
• Meeting the Health Needs of First Nations with
  more timely and higher quality of care
• Fostering Reciprocal Accountability to improve
  the overall management of the Program
• Adopting a Community Health Approach to draw
  linkages with community health programs for the
  advancement of First Nations health and
  well-being.

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First Nations Health Action Plan Non-Insured
Health Benefits (ctd)

• Building Blocks
• Clear mandate and policies
• Reasonable rate of annual growth
• Ensuring needs-based eligibility criteria
• Transparency in Federal Corporate Administration
  Expenses
• Tri-partite service agreements
• First Nations Charter of Rights and
  Responsibilities
• Linkages with community-based programming
• First Nations Health Reporting Framework.

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First Nations Health Action Plan Health
Reporting Framework

• Built on reciprocal accountability OCAP
  principles
• Response to pan-Aboriginal HRF initiative of FPT
  governments
• Health Determinants approach
• Released for discussion June 2005

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First Nations Health Action Plan Public Health
Framework

• FPT Advisory Committee on Public Health and
  Naylor Report recognized that greater public
  health risks are in First Nations communities.
• Naylor recognized that First Nations are not
  simply stakeholders but have aspirations of
  self-determination that factors into the
  effectiveness of public health intervention.
• Support for First Nations Public Health
  Infrastructure required with Inter-jurisdictional
  partnerships
• AFN Advisory Committee on Public Health
• First Nations Public Health Framework released
  for regional dialogues in Summer 2005.

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Follow-Up to FMM Federal Investments of 700M

• Federal government announcements
• 200M Aboriginal Health Transition Fund
• Integration and adaptation of services (national/
  regional/ local initiatives)
• 100M Aboriginal Health Human Resources
  Initiative
• 400M Upstream Investments
• Suicide prevention
• Diabetes
• Maternal and child health
• Aboriginal Head Start

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Follow-up to FMMBlueprint

• Goals
• Access through integration and adaptation
• Equitable access to Canadian health care
  improvements in Ten-Year Plan
• Upstream investments
• Clarify Roles and Responsibilities
• First Nations Specific Framework
• Recognized role of First Nations governments in
  delivering health services
• To be presented at Fall 2005 First Ministers
  Meeting on Aboriginal Issues

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Follow-up to FMMBlueprint (ctd)

• National Approach
• FTPA Planning Group
• ADM/NAO Core Group (Ont/FNIHB Co-Chair)
• Ministers/NAO Leaders
• National Framework
• Blueprint Approach
• Blueprint Outline
• Glossary
• Submission Template

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Follow-up to FMMBlueprint (ctd)

• Action Agendas
• Delivery and Access
• Sharing in Improvements to Canadian Health Care
• Promoting Health and Well-Being
• Monitoring Progress and Learning as we go
• Clarifying Roles and Responsibilities between
  F/P/T/First Nations governments and organizations
• Developing Ongoing Collaborative Working
  Relationships

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National Engagement Processes

• National FN Health Policy Summit, Oct. 28-29
• Health Sectoral Session, Nov. 4-5
• Initiation of Blueprint Development
• Resolution at December 04 Assembly
• Mandated CCOH and National Chief to negotiate a
  FN specific stream and resources for
  national/regional
• Other related activities
• May Cabinet Retreat
• FMM on Aboriginal Issues preparations
• First Nations Governments Special Assembly
• AFN Policy Summit on Housing, Education,
  Environmental Stewardship

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Regional Engagement Processes

• First Nations Regional Processes (each receiving
  200K)
• Regional Coordination/Partnership Team
• Community meetings
• Chiefs Task Force/Working Group/Policy Table
• Meeting with NGOs
• Tri-partite discussions
• Chiefs Assemblies
• Participation in national events
• Long-term planning for mutually beneficial
  linkages with P/Ts and FNIHB in Strategy
  development

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Critical Steps for Success of First Nations
Specific Blueprint

• National
• May Cabinet Retreat
• National Engagement Session with FNIHB, June
  16-17
• CCOH Special Meeting on First Nations
  Jurisdiction
• Clarifying the federal relationship will be key
  to assuring First Nations that this is not an
  offloading strategy
• Submission of Regional Blueprints in June/July
• Presentation of National Update at July AGA in
  Yellowknife
• Presentation of Final Blueprint to First Nations
  at pre-FMM National FN Health Policy Summit
  (September)

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Critical Steps for Success of First Nations
Specific Blueprint (ctd)

• Regional
• CCOH motion to support regional First Nations
  funding proposals
• P/Ts cannot be expected to take a lead role in
  creating a FNs specific framework
• Integrity of Regional First Nations Blueprints
  maintained in National Roll-Up

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Critical Success Factors for National First
Nations Blueprint

• Strengthen the role of First Nations governments
  in improving the health and well-being of their
  peoples, living in and outside their communities
• Working Nation-to-Nation with federal, provincial
  and territorial governments to establish
  collaboration/coordination
• Adequate access to health human resources and
  infrastructure

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Critical Success Factors for National First
Nations Blueprint

• 2. Securing equitable opportunities for health
• Areas within Ten-Year Plan for Canada where there
  is no equivalent investment for First Nations,
  such as
• Escalator - Sustainability
• Health Infostructure (research and technology)
• Primary and Continuing Care
• Healthy Living (Healthy Schools)
• Catastrophic Drug Coverage

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Critical Success Factors for National First
Nations Blueprint

• 3. Obtaining support for a holistic approach to
  community health, including addressing
  determinants
• Housing, Education, Economic Development
• Mental Health
• 4. Fostering Reciprocal Accountability to measure
  improvements
• Based on Government-to-Government relations
• First Nations Health Reporting Framework

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Conclusion

• A First Nations specific framework and process
  must result in
• Alignment with Historical Foundation of First
  Nations-Canada Relationship
• An Ongoing Commitment Towards Transformative
  Agenda
• An Action-Oriented Agenda
• A Needs Based and Holistic Approach