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B.C. First Nations carve new path with independent health authority
On Tuesday (Oct. 1) the federal government officially handed over control of First Nations health programs in B.C. to the independent First Nations Health Authority.
Almost two years ago, on Oct. 13, 2011, representatives from the federal and provincial governments and B.C. First Nations gathered at the Capilano Longhouse on the Squamish First Nation reserve for the signing of the unprecedented B.C. Tripartite Agreement on First Nations Health Governance.
A one-time funding of $17 million was given to support the implementation and transition costs for the establishment of the FNHA. Going forward, Ottawa will allocate $380 million a year (over 10 years) for a total of $4.7 billion, while the province will contribute $83.5 million.
The FNHA, whose headquarters are in an office building at Park Royal South, will now assume control of financing and delivering programs historically handled by Health Canada’s First Nations Inuit Health Branch.
“This has been a long time coming,” FNHA chief executive officer Joe Gallagher told The Outlook on Monday. “This transfer of the services represents a significant milestone along this journey.”
Starting this week, 150 Health Canada employees will amalgamate with 100 staff members already working out of the FNHA’s Park Royal office. Gallagher said the terms of employment for those Health Canada workers will not change under the new model.
“As part of this, we have obligations to honour the collective agreements they have in place through the federal unions,” explained Gallagher.
There will, however, be new training around health and wellness philosophies as they relate to First Nations health. According to Gallagher, there’s now an opportunity for the FNHA to custom-tailor health care programs.
“That notion that a lot of things that happen to people are preventable. To shift the acute care to a preventive model,” said Gallagher.
Status B.C. First Nations have a diabetes rate 40 per cent higher than the general population. As the FNHA moves forward and tailors their health programs to the meet the needs of First Nations, several key areas will be addressed: increased physical activity, stress management, reducing tobacco use, proper body weight and better nutrition.
“We, as First Nations people, have a vested interest in taking care of our health and living well longer,” said Gallagher.
Now that the FNHA is at the same table as the B.C. Ministry of Health, both parties will work together to coordinate and integrate their respective health programs and services.
“There is a lot of do, a lot of unmet needs that need to be addressed,” said Gallagher. “For a lot of [First Nations] people that don’t have family physicians, the emergency room becomes primary care.”
Oral hygiene is another area of concern. For aboriginals in B.C., dental coverage falls under a non-insured health benefit program.
Gallagher said there have been some inconsistencies on how dental fees are collected, with some dentists requiring advancement payment. This has discouraged some First Nations people from visiting the dentist.
The FNHA hopes to address these concerns by having conversations with the College of Dental Surgeons of B.C.
In terms of accountability, the FNHA will undergo annual audits conducted by an independent auditor. Those financial statements will be submitted to the federal government, along with the FNHA’s annual reports, said Gallagher.
For the approximately 150,000 B.C. aboriginals — including 2,500 residents living on the Squamish Nation and Tsleil-Waututh reserves — whose health care now comes under the responsibility of the FNHA — the transition is expected to be seamless, said Gallagher.