Evan Adams, MD, MPH Deputy Provincial Health Officer Office of the Provincial Health Officer Ministry of Health May 1, 2013

There are an estimated 370 million Indigenous people living in over 70 countries worldwide. They present a rich diversity of cultures, religions, traditions, languages & histories yet they continue to be among the world's poorest & most marginalized populations.

 An official definition of “Indigenous" has not been adopted by the United Nations system due to the diversity of the world’s Indigenous peoples. Instead, a modern & inclusive understanding of “Indigenous" has been developed & includes peoples who:

Have strong links to territories & surrounding natural resources.

“Aboriginal people are at the bottom of almost every available index of socioeconomic well-being, whether [they] are measuring educational levels, employment opportunities, housing conditions, per capita incomes or any of the other conditions that give non-Aboriginal Canadians one of the highest standards of living in the world.”

Leadership Accord (2005) The New Relationship (2005) The Transformative Change Accord (2005) One of the purposes of the TCA is to bring together the three parties to achieve goals of closing the social & economic gap between First Nations and other British Columbians over the next 10 years.

Signed June, 2007, by the Tripartite partners to build on the bilateral Transformative Change Accord: First Nations Health Plan. Commits the partners to take action in: –Governance, Relationships & Accountability –Health Actions – Health Services, Health Promotion & Disease & Injury Prevention, & Performance Tracking –Implementation, Oversight & Community Engagement

Governance Health Actions One Plan

Outcomes of Governance Work: o Effective & accountable First Nations, in full partnership with BC & Canada o Culturally-responsive system o Efficient & sustained delivery structure (no duplication) o First Nations health care needs & priorities met o Better First Nations health outcomes

Implementation – Provincial, regional, &/or local Planning level – Provincial / Regional Strategic level – Provincial overview

Tripartite Management Team Primary Care & Public Health Mental Health & Addictions Maternal & Child Health Health Human Resources eHealth Health Planning & Capital Health Knowledge & Information

* Emergency Response to Natural Disasters in First Nations Communities: Roles and Responsibilities (First Nations & Inuit Health, Health Canada) * First Nations Health Emergency Management Working Group - Understand & respect First Nations - Collaboration to clarify complex web or organizational roles - Increase linkages to the FNHA - Flow charts & algorithms w/ contacts please

Basis Agreement initialled by negotiators July 2010 BC Tripartite Framework Agreement on First Nations Health Governance signed October 13, 2011

Federal Undertakings Section 6.3(1) Canada shall... provide funding to the FNHA to support the transfer of Federal Health Programs… in phases or blocks as agreed… within two years of signing.

A new Health Governance Structure where First Nations plan, manage, design & deliver certain health programs & services A more integrated Health System with stronger linkages between service providers & reflective of BC First Nations cultures & perspectives Facilitates discussion of the determinants of health Provision of health care access at minimum comparable to those in similar locations Reciprocal accountability

Support a regional structure which allows First Nations to collaborate among themselves to plan, design, deliver & manage a range of health services to First Nations people in BC Establish working relationships & reciprocal accountability processes with Health Canada, BC Ministry of Health, regional Health Authorities & other providers Work with partners to integrate First Nations models of wellness. Develop Health information systems & protocols for information sharing/surveillance Work with broad partners to address social determinants

We have been concluding Sub-Agreements to describe how the transfer of First Nations & Inuit Health Branch (FNIHB)-BC Region (Health Canada) to the First Nations Health Authority will take place – by October 1, We have been working in our regions to conclude arrangements & partnerships with regional Health Authorities.

Coming together to address issues High quality education for our children & families Proper Housing Prosperity & Wealth Strong culture & Traditions Evidence of healthy activities & sport Valuing our lands & territories