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Directives

​​​Since 2008, BC First Nations have been involved in an unprecedented process of community engagement to guide the work in First Nations health governance. Through hundreds of regional and sub-regional caucus meetings, and Health Partnership Workbooks, First Nations in BC have developed the following directives. These directives describe the fundamental standards and instructions for the new health governance relationship.

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​Directive #1: Community-Driven, Nation-Based

• The Community-Driven, Nation-Based principle is overarching and foundational to the entire health governance arrangement.

• Program, service and policy development must be informed and driven by the grassroots level.

• First Nations community health agreements and programs must be protected and enhanced.

• Autonomy and authority of First Nations will not be compromised.

 

Directive #2: Increase First Nations Decision-Making and Control

• Increase First Nations influence in health program and service philosophy, design and delivery at the local, regional, provincial, national and international levels.

• Develop a wellness approach to health including prioritizing health promotion and disease and injury prevention.

• Implement greater local control over community-level health services.

• Involve First Nations in federal and provincial decision-making about health services for First Nations at the highest levels.

• Increase community-level flexibility in spending decisions to meet their own needs and priorities.

• Implement the OCAP (ownership, control, access and possession) principle regarding First Nations health data, including leading First Nations health reporting.

• Recognize the authority of individual BC First Nations in their governance of health services in their communities and devolve the delivery of programs to local and regional levels as much as possible and when appropriate and feasible.

 

Directive #3: Improve Services

• Protect, incorporate and promote First Nations knowledge, beliefs, values, practices, medicines and models of health and healing into all health programs and services that serve BC First Nations.

• Improve and revitalize the Non-Insured Benefits program.

• Increase access to primary care, physicians, nurses, dental care and other allied health care by First Nations communities.

• Through the creation of a First Nations Health Authority and supporting a First Nations population health approach, First Nations will work collectively to improve all health services accessed by First Nations.

• Support health and wellness planning and the development of health program and service delivery models at local and regional levels.

 

Directive #4: Foster Meaningful Collaboration and Partnership

• Collaborate with other First Nations and non-First Nations organization and governments to address social and environmental determinants of First Nations health (e.g. poverty, water quality, housing, etc.).

• Partnerships are critical to our collective success. First Nations will create opportunities through working collaboratively with federal, provincial, and regional partners.

• Foster collaboration in research and reporting at all levels.

• Support community engagement hubs.

• Enable relationship-building between First Nations and the regional health authorities and the First Nations Health Authority with the goal of aligning health care with First Nations priorities and community health plans where applicable.

 

Directive #5: Develop Human and Economic Capacity

• Develop current and future health professionals at all levels through a variety of education and training methods and opportunities.

• Result in opportunities to leverage additional funding and investment and services from federal and provincial sources for First Nations in BC.

• Result in economic opportunities to generate additional resources for First Nations health programs.

 

Directive #6: Be Without Prejudice to First Nations Interests

• Not impact on Aboriginal Title and Rights or the treaty rights of First Nations, and be without prejudice to any self-government agreements or court proceedings.

• Not impact on the fiduciary duty of the Crown.

• Not impact on existing federal funding agreement with individual First Nations, unless First Nations want the agreements to change.

 

Directive #7: Function at a High Operational Standard

• Be accountable, including through clear, regular and transparent reporting.

• Make best and pruden​t use of available resources.

• Implement appropriate competencies for key roles and responsibilities at all levels.

• Operate with clear governance documents, policies, and procedures, including for conflict of interest and dispute resolution.​


 

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