Portfolio Holder/Alternates: Grand Council Chief Patrick Madahbee, Chair; Grand Chief Jonathon Solomon, Alternate Chair, Mushkegowuk Tribal Council
Ontario Chiefs Committee on Health: Chief R. Donald Maracle, AIAI, Chief Karen Loran, IFN; Deputy Grand Chief Jason Smallboy, NAN; Chief Peter Collins, UOI; and Chief Kathy Kishiqueb, GCT #3.
Health Coordination Unit: Suzanne Nicholas, AIAI; Lyndia Jones, IFN; Loretta Sheshequin, NAN; Jamie Restoule, UOI; Noella Mandamin, GCT #3, and Lori Davis Hill, Six Nations
The Health Coordination Unit (HCU) is the technical and advisory body operating under the umbrella of the Chiefs of Ontario. It is comprised of the Health Directors of the four associations and one representative from the Independent First Nations and a representative from Six Nations of the Grand River. The Unit receives support through the coordinating capacity of the Chiefs of Ontario office. The Health Coordination Unit is responsible to the Ontario Chiefs Committee on Health, the Political Confederacy (PC) and the Chiefs in Assembly.
The Second quarter of this year has been busy time, the AOCC was an opportunity to present all the initiatives to update the Chiefs and renew and follow up on the mandates from the Chiefs.
Mental Health Funding – Provincial and Federal
- Ontario’s First Nations Health Action Plan announced investments in Home and Community Care, Primary Care, Public Health and Health Promotion, and Life Promotion and Crisis Support.
- The Journey Together, in response to the Truth and Reconciliation Commission calls to action, also includes significant investments in mental health and addictions through closing gaps and removing barriers. Under The Journey Together, MCYS identified funding to support a number of youth Life Promotion and crisis support activities, including mental health teams, recreational and cultural programming and Land-based programming, as well mental health and addictions workers for schools on reserve and enhancements to telemedicine. Health Canada FNIHB announced mental health enhancement funding. In Ontario Region, the plan to combine federal and provincial resources to create mental wellness teams was agreed to. Selected options by PTOs and discussions occurred over the summer regarding the selection of hosts for the teams, team development, and implementation. At the current time, 19 teams are being discussed with the PTOs with the exception of the IFN communities which remain in discussion with government. Teams are expected to be operational by end of October 2017.
- The Ministry of Children and Youth Services (MCYS) is investing in culturally appropriate youth life promotion and suicide prevention supports for Indigenous children and youth through Ontario’s First Nation Health Action Plan and The Journey Together: Ontario’s Commitment to Reconciliation with Indigenous Peoples. These new annual investments are valued at $17M for 2017-18 and growing to $23M at maturity in 2018-19 and ongoing.
- MCYS plans to move forward to annualize investments and roll-out initiatives.
- Enhancing the Tele-Mental Health Service to enable more outreach to Indigenous communities and additional specialized consultations;
- Allocating holistic response funding to Provincial Territorial Organizations (PTOs) and urban Indigenous partners, mirroring the funding approach used for the Family Well-Being Program (based on the number of communities/service sites, with consideration built in for communities/organizations that have concentrated populations); and,
- Allocating funding to PTOs to support the recruitment of a mental health and addictions worker and/or mental health supports for each of the First Nations schools in Ontario by 2018-19.
In May 2016, the Ontario government announced an investment of nearly $222 million over three years, “…To ensure Indigenous people have access to more culturally appropriate care and improved outcomes.” The initial investment will be followed by sustained funding of $104.5 million annually to address health inequities and improve access to culturally appropriate health services over the long term.
As part of the seniors’ care component of the First Nations Health Action Plan, “…The province will continue to work with Indigenous partners to invest $25 million over three years and $14 million ongoing in home and community care. Long-term collaboration will ensure that these investments are culturally appropriate, safe and effective. A First Nations’ advisory committee was established. The committee’s report was completed and the highlights presented at the AOCC. The process for release of resources for the fiscal year was agreed to; that being equal distribution to all First Nation communities, and with approval, these funds flowed directly to communities. For the upcoming fiscal year (18/19) an allocation formula will be approved by leadership for the sustained funding. Federally, Home & Community care also received budget increases. This fiscal year, the initial resources will be disbursed to the communities who only have a part-time homecare worker. For subsequent years, a formula will need to be developed for roll out for all communities in fiscal year 2018/2019.
Long Term Care Homes
Follow-up from AOCC resolution 22/17 established a tripartite working group to develop recommendations for improving First Nations access to Long Term Care Homes on reserve. This working group will be expected to identify demographic trends, needs within First Nations, explore various models that may work (including a “blended” or “mixed” model), and identify potential funding arrangements while keeping in mind that there are limited resources, while the need to be creative is necessary to maximize dollars from various sources. It was agreed in order to promote efficiency, and yet ensure that the working group is representative of all First Nation regions in Ontario, that each PTO, the Independent First Nations and Six Nations will be asked to appoint one representative each to this working group. MOHLTC, Health Canada and INAC will also be represented on the working group, and the mandate will commence once all members are appointed.
The working group will have its first meeting September 26th, 2017.
In January 2016, a complaint from First Nations Child and Family Caring Society of Canada (FNCFCSC) and Assembly of First Nations (AFN) was again upheld by the Canadian Human Rights Tribunal (CHRT). The Government of Canada was ordered to cease applying its narrow definition of Jordan’s Principle, and take measures to implement its full meaning and scope.In addition to the full implementation of Jordan’s Principle, Canada is actively working on improving access to health and social services for First Nations children through child first initiatives, including committing up to $382.5 million over three years.
Health Canada (HC) and Indigenous and Northern Affairs Canada (INAC) are implementing Jordan’s Principle with First Nations partners and provinces and territories. Partners are actively engaged to ensure First Nations children receive needed care and services. In Ontario Region, a decision was made to implement First Nations Focal Points (JP Navigators) in each PTO, Independent First Nations, and Six Nations of the Grand River. The JP Navigators are funded by FNIHB- Health Canada, who are the lead government department.
These focal points are working with all First Nation children and families to guide them to the appropriate supports and services, and help them navigate federal and provincial or territorial systems. In addition, they will identify unmet needs which will facilitate the development of options for a proactive model of care moving forward for 2017-2019 and beyond.
To date the JP Navigators have been actively working with families to ensure that children’s needs are being met under the terms of the CHRT decisions. However there are challenges to the process. These challenges have been identified and the JP Navigators will look to the COO process to support, and provide clarification with government partners regarding coordination and administrative processes.
Transformation of the Health System Initiative:
First Nations have been engaged in discussions with the Province to transform the health system to make it more responsive and effective for First Nations in Ontario. The First Nations Health engagement process is set to commence in the fall 2017 and will involve conducting engagement sessions throughout Ontario. It is expected that the Provincial-Territorial Organization, Independent First Nations and unaffiliated First Nation will determine how they would like to structure their respective sessions and COO Health Secretariat is available to support each regional process. The anticipated outcome of these sessions is a report summarizing key recommendations setting out how the health system in Ontario needs to change to be more effective for First Nations. It is expected that there will for funding changes.
Focus for next Quarter
- Follow up with the Federal government on Federal budget allocations for First Nations beginning in fiscal year 2018/019.
- Follow up with Provincial government on the outcomes of the Journey together process as well as the First Nations Health Action plan.
- Working with Leadership on future dialogue on legalization of cannabis from the public health perspective.
- Support Leadership in seeking clarification on health services in relation to the announcement of Minister Philpott moving to INAC and working on indigenous services that builds on the accomplishments of her previous work as Minister of Health.
Annual Health Forum Feb 27 28 & March 1 2018 Theme “Community Voices”