Vertical and Horizontal Integrated Management of the Labrador Innu Comprehensive Healing Strategy (LICHS) Canadian Public Health Association Conference June 3,2008 Presenters: Gail Baikie & Barbara Guy

Purpose Evolving model of Integrated Management in the Labrador Innu Comprehensive Healing Strategy (LICHS) The LICHS context – federal/provincial/Innu relationships

Context Labrador Innu – Mushuau (pop. 800) and Sheshatshiu (pop.1800) Nomadic and geographically isolated until 1960s Under Terms of Union with Newfoundland (1949) Innu did not come under the Indian Act Initial crisis 1990s – leading to Mushuau Innu Relocation Agreement (MIRA) Mushuau Innu relocate from Davis Inlet to Natuashish in youth gas sniffing crisis in both communities LICHS ( ) 5 components: community policing, programs and services, relocation of Davis Inlet to Natuashish, reserve creation and registration under the Indian Act and community health Current LICHS (2005 – 2010)

LICHS Integrated Structures and Initiatives Main Table – tri-partite collaboration, negotiation and info- sharing Steering committee LICHS formative evaluation 2003 First design of IM office Sub-committees of MT Operational LICHS and community level Operations Committee

Current LICHS ( ) Focus: Horizontal Integrated Management Capacity Development (Governance & Services) Physical Infrastructure Health/Social/Education Programs

First Nation Determinants of Health LICHS Phase II Objectives Horizontal Integrated Management Building a Physical, Social, Health Foundation for Healing & Development Enhancing Innu Governance

Integrated Management: Current Structure Chief Federal Negotiator Lead on LICHS & Land Claims Maintables Supported by Director of Integrated Management & Senior Federal Negotiator LICHS Maintable (tripartite) with sub-committees (Health & Healing, Education, Child Youth & Family Services) Federal Interdepartmental Integrated Management Committee Building Horizontal & Vertical Cooperation and Coordination Improved relationship and scope of action in federal relationship with Innu and Province Building relationships across sectors (NGO, Universities….) Director of Integrated Management – Joint HC & INAC Office (Sept ) Supports Vertical Collaboration between local, regional and national (service delivery, operations, policy)

Outcomes Role of Director: Non-administrative; Functional reporting relationships; Diverse Perspective and Skill Set (Breadth expertise and opposed to depth expertise); A ‘Federal’ Vs ‘Departmental’ perspective Major initiatives: Capacity Building; Intoxicant Bylaw; Education and Child Youth Family Services Devolution short term: responsiveness has increased, formal avenue for discussion and direction long term: stronger structure to support linkages. E.g. comprehensive community planning (INAC) to community health planning (HC) Benefits to federal government – perception, opportunities, coordinated efforts Benefits to Innu – mobilized efforts on priorities; one window access Challenges: Incompatible Administrative Systems; Maintaining the Vision for Integration (and Collaboration); Building Relationships (informal) but require formal; Relationships are tenuous Building on the Past – Responding in the Present – Preparing for the Future

Results - Policy implications The lack of a joint program framework, with a comprehensive understanding of roles and potential impact, affected the timeliness of integration work – A ‘Will’ Without the ‘Way’ Conceptual policy work to support programming and planning linking Innu stated vision for healthy communities, literature on healing and community development, and LICHS goals and programs – From Reactionary to Strategic Health and healing are central to the work, are shared objectives, and can be affected by more than programs. Integration has furthered this understanding – From ‘Your’ Responsibility to ‘Our’ Responsibility

Questions