First Nation Health Governance and Relationship Framework Between First Nation Leadership in Ontario and the Ministry of Health and Long-Term Care
TO: FIRST NATIONS LEADERSHIP
FROM: ONTARIO REGIONAL CHIEF ISADORE DAY
DATE: APRIL 27, 2016
RE: UPDATE: FIRST NATION HEALTH GOVERNANCE AND RELATIONSHIP
FRAMEWORK BETWEEN FIRST NATION LEADERSHIP IN ONTARIO AND THE MINISTRY OF HEALTH AND LONG-TERM CARE (Follow-Up to Communique Dated January 29, 2016)
ISSUE SUMMARY:
Since the Ministry of Health and Long Term Care (MOHLTC) released its discussion paper entitled “Patients First: A Proposal to Strengthen Patient-Centred Health Care in Ontario” in December 2015 (which outlines proposed changes for the health system in Ontario) the Chiefs of Ontario (COO), through the Political Confederacy (PC), have held a series of meetings to determine an appropriate response. Recognizing and respecting, the Political Accord which was signed between First Nation Leadership and the Province of Ontario in August 2015, the PC has identified the need for the following:
- Development of a First Nation Health Governance and Relationship “Framework” which builds on, and is consistent with, the broader 2015 Political Accord;
- Creation of a First Nation Health Position Paper which outlines First Nation-responsive requirements and engagement processes necessary to facilitate “transformative change” within existing and future health care delivery systems in Ontario;
- A Special Chiefs Assembly (SCA) on Health (to be held in Fall 2016) to ratify the Governance and Relationship Framework as well as the Health Position Paper.
BACKGROUND:
At the June 2008 All Ontario Chiefs Conference, First Nation Leadership introduced Resolution 08/32 (subsequently passed by a PC Motion in September 2008) calling for the development of a First Nation Health Accord “to guide the consideration of health policy matters and government-to-government negotiations at the local level, and would include an opt-out clause for individual First Nations”. Several drafts of the proposed Health Accord were developed in concert with First Nation Leadership and COO technical staff. This effort stalled at the time due mainly to a lack of Provincial government political support.
In August 2015, First Nation Leadership in Ontario signed a broader Political Accord with the Province of Ontario. This historic document revitalized the opportunity, once again, to pursue discussions focused on developing a Bilateral Health Accord.
On December 17, 2015, the Minister of Health released Ontario’s Patients First: A Proposal to Strengthen Patient-Centred Health Care in Ontario, and through accompanying correspondence to Regional Chief Day, invited First Nations in Ontario to collaboratively identify the necessary steps to “meaningfully engage with First Nations as partners through a bilateral process” and “to configure transformative change for First Nations’ Health in Ontario”.
Throughout January to early April 2016, various First Nation political and technical bodies have met including the PC; the Ontario Chiefs Committee on Health; and the COO Health Coordination Unit. In late January, a joint technical team with COO and MOHLTC representatives was also struck to assist in exploring and identifying the processes required to achieve the necessary “transformative changes” which would result in better health outcomes and status for First Nation peoples.
Based on these preliminary discussions and review, on April 8, 2016, the PC convened and passed a Motion of Action directing the following:
- Creation of a First Nation Health Governance and Relationship “Framework” (yet to be confirmed as MOU/MOA/Protocol Agreement) which builds on, and is consistent with, the First Nations and Government of Ontario Political Accord signed in August 2015. This product could also potentially serve as an “implementation model” for other sectors (i.e. Social, Education, Environment, etc) seeking to implement the principles and spirit of the 2015 Political Accord.
- Development of a First Nations Health Position Paper that investigates and assesses both current and future health service delivery programs and practices as well as defines distinct engagement processes to ensure that First Nations Leadership and health providers are meaningfully, and appropriately, involved as this process moves forward.
- Securing the necessary resources to ensure the aforementioned documents are achieved as well as funding to conduct a Special Chiefs Assembly on Health in Fall 2016 to review findings to date and approve future activities including the First Nation engagement process (es).
NEXT STEPS:
Leadership recognizes the importance of ensuring that First Nations are actively involved in identifying the existing challenges regarding First Nation relationships especially in relation to Local Health Integration Networks (LHINs) structures and funding models. In particular, the potential impacts on the long-term and palliative care needs of community members as the Province’s internal reforms unfold.
In addition, while current activities and discussions are predominantly bi-lateral in nature, it is clear that the roles and responsibilities of Health Canada and First Nations & Inuit Health Branch (FNIHB)-Ontario Region are also significant. Their participation has yet to be determined.
First Nation legal counsel has been retained to assist in monitoring and contributing to any proposed Provincial legislative amendments, which may impact First Nation health service delivery and to ensure that our community and client interests are duly recognized and protected.
If you require further information please contact Tracy Antone, Director of Health, at tracy@coo.org
