Blueprint on Aboriginal Health: Approach for a First Nations Specific Framework CSSSPNQL June 2005.
-
Upload
brice-hanchett -
Category
Documents
-
view
212 -
download
0
Transcript of Blueprint on Aboriginal Health: Approach for a First Nations Specific Framework CSSSPNQL June 2005.
Blueprint on Aboriginal Health:Approach for a First Nations Specific Framework
CSSSPNQLJune 2005
Discussion Points
FPT LandscapeNational Chief’s 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
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
Significance of First Nations for F/P/T Landscape
First Nations population is larger than that of four provinces in CanadaHistorical 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 communitiesFirst Nations have the power to exercise jurisdiction and by-law making authority in the area of maintaining public health and safety
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 RoundtableFirst Ministers Special Meeting on Aboriginal Health, Sept. 04Cabinet-Aboriginal Leadership Policy Retreat
Real Engagement
Governments’ commitment to transformative change – underlying social and economic framework
that perpetuates inequitiesRecognition 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
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
National Chief’s Getting Results Strategy
Recognizing and Implementing First Nations GovernmentSecuring the Place of First Nations in Canada and the WorldStrengthening First Nations Communities– First Nations Health Action Plan
GRS Policy Development
Building collaborative relationships with F/P/T jurisdictions that move beyond consultation to joint policy development;Key steps:
1.Engage First Nations leaders;2.Host National Dialogues;3.Seek Independent First Nations expertise;4.Secure government mandate for change;5.Undertake joint national policy processes.
First Nations Health Action Plan:Sowing the Seeds
Dec/03, Minister of Health invites AFN to submit a proposal re. seat at FPT Advisory Committees on HealthFeb/04, National Chief requests involvement in the Council of the FederationApr/04, first Canada-Aboriginal Peoples Roundtable– Minister Pettigrew
recognizes the federal government’s fiduciary obligation in First Nations health
May/04, Premiers Campbell and McGuinty meet with AFNJune/04 Premier Campbell and National Chief agreed to seek approval for a joint presentation to the Council in JulyRegional Chief Erasmus presents to the Western Premiers Meeting, July 2004National Chief meetings with RomanowNational Chief participates at September 13, 2004, First Ministers Meeting
First Nations Health Action Plan
Sustainable
Financial Base
GETTING RESULTSGETTING RESULTS
First Nations controlled and sustainable health system that
adopts a holistic, culturally appropriate approach
Sust
ainab
ility
Integrated Primary & Continuing
Care
Health Human
Resources
Public Health Infra-
structure
Healing and
Wellness
Information and
Research Capacity
Integration
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
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:
1.Meeting the Health Needs of First Nations with more timely and higher quality of care;
2.Fostering Reciprocal Accountability to improve the overall management of the Program;
3.Adopting a Community Health Approach to draw linkages with community health programs for the advancement of First Nations health and well-being.
First Nations Health Action Plan: Non-Insured Health Benefits (ctd)
Building Blocks:1.Clear mandate and policies;2.Reasonable rate of annual growth;3.Ensuring needs-based eligibility criteria;4.Transparency in Federal Corporate
Administration Expenses;5.Tri-partite service agreements;6.First Nations Charter of Rights and
Responsibilities;7.Linkages with community-based
programming;8.First Nations Health Reporting Framework.
First Nations Health Action Plan: Health Reporting Framework
Built on reciprocal accountability & OCAP principlesResponse to pan-Aboriginal HRF initiative of FPT governmentsHealth Determinants approachReleased for discussion June 2005
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.
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
Follow-up to FMM:Blueprint
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
Follow-up to FMM:Blueprint (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
Follow-up to FMM:Blueprint (ctd)
Action Agendas:1. Delivery and Access2. Sharing in Improvements to Canadian
Health Care3. Promoting Health and Well-Being4. Monitoring Progress and Learning as we go5. Clarifying Roles and Responsibilities
between F/P/T/First Nations governments and organizations
6. Developing Ongoing Collaborative Working Relationships
National Engagement Processes
National FN Health Policy Summit, Oct. 28-29Health Sectoral Session, Nov. 4-5Initiation 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
Regional Engagement Processes
First Nations Regional Processes (each receiving $200K)Regional Coordination/Partnership TeamCommunity meetingsChiefs Task Force/Working Group/Policy TableMeeting with NGOsTri-partite discussionsChiefs AssembliesParticipation in national eventsLong-term planning for mutually beneficial linkages with P/Ts and FNIHB in Strategy development
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)
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
Critical Success Factors for National First Nations Blueprint
1. 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
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
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
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