The Senior Executive Team of the FNHA welcoming attendees at the 2013 Gathering Wisdom for a Shared Journey VI conference.
There’s a new health authority in British Columbia. On October 1, 2013, the First Nations Health Authority (FNHA) – an initiative sponsored and led by BC’s First Nations – officially assumed all regional program and health service delivery responsibilities from Health Canada’s First Nations and Inuit Health Branch (FNIHB) Pacific Region, as well as some headquarter functions based in Ottawa. “We flipped the switch and employees that were once with Health Canada are now First Nations Health Authority staff,” says David Huh, FNHA Director of eHealth, Information Management and Privacy. “All corporate functions continue to operate, and we were able to complete the transfer with minimal disruption to communities.”
The assumption of health services by the FNHA did not happen overnight. In 2005, BC’s First Nations, along with the BC and federal governments, signed the tripartite Transformative Change Accord which acknowledged the importance of First Nations’ governance as a contributing factor to healthy First Nations and Aboriginal communities. The Accord called for action plans and/or agreements to support First Nations oversight of health care, laying down the foundation for an historic and innovative approach to First Nations and Aboriginal health care in British Columbia. Since then, the three parties have worked together to shape and build the current governance and organizational structures that will allow BC First Nations to oversee the health care of their people within the existing local, provincial and national frameworks.
“It’s very important to understand that BC First Nations are driving FNHA activity,” says Huh. “The work is Community-Driven, Nation-Based. It’s driven by the needs of the collective, not the individual. Our unique process challenges every [BC First Nations] community, every community member to see their role in the process. We cannot make this work without joint participation and reciprocal accountability. You cannot expect to make change if you’re not going to be part of that change.”
Governance of BC First Nations health involves four new bodies:
- The First Nations Health Authority (FNHA) oversees planning, management, service delivery, and funding of on-the-ground programs and services for BC First Nations.
- The First Nations Health Council (FNHC) provides political leadership for implementation of tripartite commitments and supports health priorities for BC First Nations.
- The First Nations Health Directors Association (FNHDA) is comprised of health directors and managers working in First Nations communities and supports education, knowledge transfer, professional development and best practices. FNHDA also advises FNHC and FNHA on research, policy, program planning and design, and the implementation of various Health Plans.
- The Tripartite Committee on First Nations Health (TCFNH) is a forum that coordinates programming and planning efforts between the FNHA, BC Regional and Provincial Health Authorities, the BC Ministry of Health, and Health Canada.
The work of all four groups is underscored by one vision: Healthy, Self-determining and Vibrant BC First Nations Children, Families and Communities. Within this vision are Seven Directives developed by BC First Nations communities:
- Directive 1: Community-Driven, Nation-Based
- Directive 2: Increase First Nations decision-making and control
- Directive 3: Improve services
- Directive 4: Foster meaningful collaboration and partnership
- Directive 5: Develop human and economic capacity
- Directive 6: Be without prejudice to First Nations interests
- Directive 7: Function at a high operational standard
Huh observes that while the FNHA has a mandate to provide health care to BC First Nations, “both Grand Chief Doug Kelly [Chair of the First Nations Health Council] and CEO Joe Gallagher have stated that we’re not trying to create a sickness system, we’re trying to create a health and wellness system.” The many projects undertaken by the FNHA reflect this philosophy, ranging from nursing services, communicable disease control, and mental wellness and substance use programs to healthy living initiatives, eHealth projects, and support for traditional medicine. (see a full list of programming)
With the transfer of services from Health Canada to the FNHA substantially completed, FNHA is now focusing on the transformation phase of their plan. This phase involves analyzing, upgrading, and re-orienting existing Health Canada programs and services to better meet the needs of BC First Nations. This process, started during the Spring of 2013, will continue for several years and will involve identifying opportunities for stronger coordination with provincial programs and services. “We’ve been fortunate to have a small, nimble executive team,” says Huh. “Our group has been able to make informed, educated decisions very quickly. The project delivery teams are able to actualize and execute on the plans that were created. We’re functioning at a high operational standard, despite the fact that we’re smaller than our health authority partners.” (FNHA has a total of 321 staff.) “It helps that the staff are so passionate and dedicated, really it’s not a job – it’s just incredible to be a part of.”
To learn more about the First Nations Health Authority, visit www.fnha.ca