Novation

Novation Fast Facts

Contribution agreement funds will continue to flow from
Health Canada from April 1-September 30, 2013.

A Three-Party Novation agreement is currently being sent
to each First Nation health service provider (agreement
recipient). This is being sent with an amendment to the
contribution agreement for fiscal years 2013/14 and
2014/15.

Signing and returning the Three-Party Novation agreement
will ensure continuity of service to your communities.

Health Canada staff are on hand to assist you with any
questions that you may have about the novation process.

Novation Presentation Video

Learn more about novation by watching our Novation presentation video!:

 

Regional sessions on Novation

image
Above: Interior region session on Novation

The First Nations Health Directors Association FNHDA in partnership with Health Canada, and the FNHA, recently hosted five Regional information sessions on Novation. - that is, the transferring of responsibility for contribution agreements currently between Health Canada's First Nations and Inuit Health Branch and First Nations communities to contracts between the new First Nations Health Authority and First Nations communities The sessions were well received -and Chiefs and Health Directors in each region participated in active dialogue about the process and administrative implications. The March 7th Vancouver Coastal region presentation was live webcast and recorded. This video presentation will be uploaded to the First Nations Health Council (FNHC) public website in the coming weeks to enable communities to access it as needed.

We are also sharing questions and answers raised during the sessions for your information and reference. Questions and answers from the sessions are enclosed for your information.

View a PDF version of the FNHDA Novation Presentation here: FNHDA Novation Presentation PDF (390 kb)

FAQs

Q) How will First Nations Agreement holders receive funds?

A) Funds will continue to flow from Health Canada for the period of April 1 to September 30, However as of October 1, 2013, the FNHA will take over payment of cash-flow funding to recipients of novated agreements. The FNHA will include an an Electronic Deposit Interface (EDI) form in the Novation package to be mailed out in March and April to all communities with novation agreements to facilitate these changes.

Q) Will there be a written assurance or guarantee that funding levels for all current programs will remain? Will there be an increase?

A) The First Nations Health Authority has committed that funding levels for current programs will be maintained. An annual increase will flow for core programs in 2013/2014 and 2014/2015. This is set out in the Framework Agreement.

Q) If a community receives a recovery letter from the Government of Canada do we still need to repay? Will these funds go to the FNHA or Canada?

A) Yes, all monies owed to Canada remain payable to the Receiver General for Canada.

Q) What happens to the current Health Canada staff that administer Contribution Agreements?

A) All full time Health Canada staff will be offered a Reasonable Job Offer or RJO from the First Nations Health Authority. They will have 60 days to decide once they get this letter. On October 1, 2013 the staff will continue to do the same work, in the same role and in the same office as they do now as employees of the First Nations Health Authority.

Q) Who will my primary contact be at the FNHA? Health Canada has Program Coordinators, AANDC has FSO's.

A) Your primary contact will not change; the same positions will be there on transfer day.

Q) Will the reporting still continue in the same way as with Health Canada?

A) The contribution agreements will have the same terms and conditions, so the reporting will be the same as it is now. The First Nations Health Authority needs to get comfortable managing current operations before making changes. Further, a community engagement process needs to take place before substantive changes will be made to Contribution Agreements. BC First Nations have clearly expressed through directive 6 of the 2011 Consensus Paper that any changes to their agreements must be made in partnership with BC First Nations.

Q) Our community is in a health planning process at the moment, will that continue? How will we be affected?

A) Yes, health planning will and must continue. As Tripartite Partners we have agreed to a number of success indicators for transition among these are: 1) to ensure no disruption and minimal adjustment required by individual First Nations people and communities to the continuation of their health services or health benefits.
2) to ensure minimal disruption and minimal added work burden on First Nations program providers who deliver community programs.

Q) What kind of transition will there be for information connected to our contribution agreements? Who holds the corporate history to address questions or concerns about past objectives?

A) All contribution agreement historical details and associated documents will continue to be available to the FNHA post-transfer.

Q) What happens to communities that do not sign Novation Agreements? Will they still receive the April funding?

A) Yes, if you have a contribution agreement, and sign the April agreement or amendment you will continue to receive funding until September 30, 2013. All Health Canada contribution agreements with First Nation Health Service providers will cease on September 30th.

Those communities who do not novate their agreements will be issued replacement agreements with the FNHA. These agreements will include the same terms, conditions and funding of prior agreements.

If replacement agreements are not signed, alternate service delivery mechanisms will be put in place to ensure mandatory health services continue to be provided to First Nations. Signing the novation agreement in a timely manner supports an uninterrupted flow of funding and services.

Q) Under the Framework Agreement, current Contribution Agreements may be cancelled within 60 or 90 days should a community not sign a Novation document; does this absolve Canada from it's obligation to provide health services to First Nations?

A) The Three Party Novation Agreement is designed to support the Framework Agreement process and to allow the FNHA to carry on current contribution agreements in place of Canada without funding or service interruptions. The Framework Agreement and the Three Party Novation Agreement are administrative in nature and do not affect or derogate from any fiduciary obligations of Canada.

Regarding termination, the Framework Agreement provides that if a First Nation health funding recipient does not sign the Three Party Novation Agreement, Health Canada will trigger the termination clause in the contribution agreement so as to allow the FNHA to assume community funding role. The FNHA would be notified of this termination and the First Nation would then be issued a replacement contribution agreement between themselves and the FNHA. The replacement agreement would follow the same terms and conditions of the predecessor agreement to ensure continuity of health funding.

Q) Terms and conditions of the current FNIHB agreements with the First Nations are guided by the following: How will these be implemented by the Three Party Novation Agreement?

• Guidelines on insurance coverage

• Administrative cost guidelines

• Ministerial audits on First Nations

• Evaluation on health programs

• 2nd and 3rd level services policy

• Movable Assets policy

• Audit requirements

• Change request of clauses to the agreement

• Intervention policy

• Notice of Budget Adjustment (NOBA) process

• Recovery of funds process

• Withholding of funds process

• Disengagement policy

• Community Workload Information System (CWIS) increases handled (the CWIS is a population count approach to track who derives benefits from the health services provided in a First Nations community)

• MOU signed with the communities – transfer of Nursing and EHO services

A) All of the above guidelines and policies will remain in place through Transition.

Post Presentation Questions:

1. The annual increase of the 5.5% referenced in the Framework Agreement – is this factored into our agreements?

The 5.5% increase set out in the Framework Agreement comes into effect in the second year of the Transfer (2014/15). It covers enhancements to Contribution Agreements and enhancements and growth factors across all programs, including Non-Insured Health Benefits, mental health services, and other programs that serve all BC First Nations.

As per the direction provided by BC First Nations and as described in the Framework Agreement, for the first two years following the transfer, Contribution Agreements will remain unchanged. This means that increases in Contribution Agreement funding will be calculated and applied as they have been in the past by FNIHB. The only difference will be that the increases for the next two years will be calculated and provided upfront at the start of the 2013/14 fiscal year.

Following the transfer, the FNHA will, in conjunction and cooperation with BC First Nations, determine the most effective use of the 5.5% annual funding increase set out in the Framework Agreement, whether that be related to Contribution Agreements, population health programs, NIHB, or other priorities.

2. What is the impact on Carry-Forwards of funding with this extension of agreements and shift to the FNHA?

Carry-Forwards will continue to apply as per the terms and conditions of the Contribution Agreements for the duration of those Agreements, including the time extension.

3. Capital Planning – will we have access to the extra Headquarters funding that we have accessed historically?

The Framework Agreement establishes a capital budget that is increased relative to what was budgeted by the Health Canada regional office in the past and capital planning and construction will continue in a seamless manner through the transfer.

The FNHA will also have access to funding provided by Headquarters for any new capital programs that may be established by the federal government.

4. Health Stations – who do they belong to? The bands? What is the Capital Plan?

The Crown has legal title to reserve lands and holds them for the use and benefit of First Nations; First Nation health Facilities located on these lands are under the control of the BC First Nations or First Nation Health Providers, and will not be transferred to the FNHA under this Agreement.

The FNHA's Capital Plan will initially consist of an Interim Capital Plan and, at the time that the Multi-Year Health Plan is developed under the Framework Agreement, a Multi-Year Capital Plan. Each of these Plans will be consistent with the Framework Agreement and describe the FNHA's Capital Facilities Program and any FNHA capital projects. The development of the Interim Capital Plan and Multi-Year Capital Plan will be undertaken by the FNHA in an open and transparent manner and based on publicly stated criteria and processes, engaging Canada, British Columbia, and regional First Nation representatives.

5. There is no cancellation clause in this Three Party Novation Agreement – it requires one.

The Three Party Novation Agreement does not require a separate cancellation or termination clause since the Contribution Agreements being transferred already include a termination clause.

6. We are a community interested in going independent on administration of our health services, stepping away from the collective (transfer group). At this stage of the transition, should we be talking to Health Canada or the FNHA?

Until September 30, 2013, you would talk to FNIHB. After the transfer, such inquires would be made directly to the FNHA. The Disengagement Policy, like all current policies, guidelines and terms of conditions of the agreements, will continue to apply for a minimum of two years.

7. Can we obtain more flexibility by developing a new agreement with the FNHA and begin making changes in programming now?

The FNHA replacement agreement would maintain the same terms and conditions of the current Health Canada contribution agreements for a two year period as required by the Framework Agreement and as directed by First Nations which indicated that there should be no disruption or changes for this period. As part of the transformation stage, the FNHA will engage with First Nations to determine priorities and opportunities for program changes.

8. The financial reporting requirements in the presentation looks like 2 year ends – one September 30, 2013 and the other March 31, 2014.

There will be only one year end with Novation. One final financial report (90 days after year end) or one Audit Report (120 days after year end) will meet the Novation Agreement requirements. In particular, for Set Programs notes to the financial statements will be required to summarize how much was spent from April 1, 2013 to September 30, 2013 (pre novation, the Ministerial funding period) and how much was spent between October 1, 2013 to March 31, 2013 (post-novation period), and a total for the full year.

Reporting on actual NIHB MT expenditures and travel completed can be challenging as there can be a lot of travel in progress on September 30, 2013.
This reporting is driven by Federal government Treasury Board requirements – the funding from Health Canada needs to be accounted for to the September 30 date. Since the financial or audit reports are due well after March 31, there should be sufficient time to separate any costs relating to travel in process around the cut-off date. However, minimal disruption to the recipient is the priority.

9. With the new bill coming through increasing the number of Status Indians, will there be any additional funding to address the needs of this increasing population on Reserve?

The Framework Agreement has a provision for this type of situation. "…in the event that Canada introduces expanded beneficiary eligibility and associated funding for any Federal Health Programs set out in schedule 3 as a result of possible legislative amendments to the Indian Act (Canada) or decisions of the courts that result in an increased number of eligible to be registered as an Indian under that Act, Canada and the FNHA will work together to determine impacts and approaches to address such change."

10. The FNHA has a 10 year agreement with guaranteed funding (via the framework agreement) – what date does this take effect?

The Canada Funding Agreement commences on the date it is signed by both parties (May 3, 2013). As per the phased transfer agreed-upon by Canada and the FNHA, funding in year one will come in two phases (July 2, 2013 and October 1, 2013).

11. The Community Based Reporting Template (CBRT) has sensitive questions that we have a hard time responding to, it is time consuming and we keep getting back our CBRT submission for revisions (we supposedly aren't doing it right).

The CBRT is not a perfect document but we must continue to use it for reporting requirements through the transition period. However, there will be opportunities through the FNHDA and FNHA to provide input and suggestions on changes for community based reporting. In the interim, for specific issues relating to your CBRT submission, please refer to your Program Coordinator.

12. What is happening in Capital?

Feasibility, design and capital construction of health facilities in progress will continue as planned within the allocated capital funding. The FNHA will be assuming and implementing Health Canada's existing three year capital plan. The FNHA will be reviewing this capital plan and corresponding capital budget after transfer.

13. Page 37 of the Framework Agreement references changes to the funding processes to best meet the health needs and requirements – we want to make changes now.

First Nations have adopted a change management strategy that sets out two stages of work: transition, and transformation. During the transition stage, the FNHA will have the ability to make some administrative improvements in the short-term, and also engage with First Nations on broader, transformative improvements. Those improvements will then be made in the transformation stage yet to come. First Nations also have the opportunity for transformative change now in the regions, through the current work underway to implement Regional Partnership Accords.

14. What is the BC Regional budget for the transfer?

The total transfer annual budget in 2008-2009 dollars is $377M. A full description of the financial commitments is set out in the Framework Agreement, and particularly in Schedules 1 and 2.

15. Why now? (implementation of the Framework Agreement)

In order to comply with the timelines established in the British Columbia Tripartite Framework Agreement on First Nation Health Governance and the direction provided by BC First Nations via resolutions passed at Gathering Wisdom for a Shared Journey IV and V.

16. Who is the First Nations Health Authority and how are they accountable to the citizens?

The First Nations Health Authority is a BC registered non-profit society which is governed by a board of directors. The structure and mandate of the FNHA were developed and approved through a consensus building process with BC First Nations leadership as reflected in Consensus papers 2011 and 2012. Please visit www.fnha.ca for detailed information.

17. Why take the Minister's place (FNHA) until the FNHA organization is ready and funding secure?

The FNHA is ready and has been provided with the funding to support the functions it will take over from Health Canada, both regionally and at headquarters level, as per the Framework Agreement and decisions arising from Gathering Wisdom for a Shared Journey forums IV and V.

18. What are we entering into?

A first for Canada, we are entering into a new way forward to improve BC First Nations health outcomes through increased control, partnerships, design and delivery of community health services.

19. Why don't you bring the conclusion of the sub-agreements back to the chief and ask for an independent evaluation?

In the early months of 2011, an independent legal review of the Framework Agreement was conducted and provided to BC First Nations. This review expressed no concerns with the Framework Agreement. Informed by this review, at Gathering Wisdom for a Shared Journey IV, BC First Nations adopted the Framework Agreement, and the 7 Directives, and directed the FNHC and FNHA to proceed with the conclusion of the technical and operational Sub-Agreements to describe the mechanics of the transfer. The Chiefs did not direct that those business agreements be brought back to the Chiefs for approval – as those Sub-Agreements flow directly from, and are consistent with, the Framework Agreement that Chiefs had already approved. In compliance with this direction, the Sub-Agreements are nearing completion and will be implemented in the coming months. Summaries of these Sub-Agreements will be available.

20. What does the organization look like? (FNHA)

Response: The FNHA functional organizational chart is available online here: http://www.fnhc.ca/pdf/fnhaorgchart.pdf.

For more information about the governance structure and mandate of the FNHA please review the Consensus Papers here:
2011: http://www.fnhc.ca/pdf/FNHC_Consensus_Paper_-_WEB.pdf
2012: http://www.fnhc.ca/pdf/iFNHA_Consensus_Paper_2012.pdf

21. What is the avenue to address concerns?

The avenue to address concerns depends on the nature of the concern. Several forums have been developed to address concerns with the BC Tripartite process. Concerns with community contribution agreements will continue to go through the process and contacts that existed historically. Political concerns with the process are addressed to regional FNHC representatives. The 2012 Consensus Paper pages 41-43 outlines the reciprocal accountability commitments that BC First Nations have agreed to at the community, regional and provincial levels. http://www.fnhc.ca/pdf/iFNHA_Consensus_Paper_2012.pdf.

22. What is the criteria for Board member's representation on the FNHA?

As directed by leadership at Gathering Wisdom V, the FNHA will transition to a regionally representative Board of Directors in April 2014. First Nations adopted Board of Directors competencies in the 2012 Consensus Paper.

23. How about a resolution to extend the implementation date to April 1, 2014 (contribution agreements)

The Framework Agreement, signed in October 2011, states that transfer will occur no later than two years after the signing. The tripartite partners are collectively committed to honouring this timetable adopted by BC First Nations. The Parties will complete the transfer by October 2013.

24. How will decision-making happen? What is the path to an answer?

Decision-making will happen at many levels, there will be decisions taken at the community level, nation-level, sub-regional, and regional levels. Province- wide decisions will be made through the process that leadership is familiar with, utilizing the community engagement pathway and consensus building process culminating at Gathering Wisdom for a Shared Journey forums. Further engagement will take place this summer to further define decision-making at the local, regional and provincial levels.

25. What is the definition of Directive #1?

First Nations defined the 7 Directives in the 2011 Consensus Paper. The definition for Directive 1 is as follows:

Community Driven and 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

26. We are expected to have faith in a structure that we don't know what it looks like yet. Can we slow this process down a bit?

The FNHA structure was defined collectively by BC First Nations, as expressed in the Consensus Paper 2012 (pages 48-52). The FNHA is operationalizing these instructions and building the necessary infrastructure to honour our commitments. The timeline is not our own, it is a shared timeline with federal and provincial governments and adopted by BC First Nations.

27. Surpluses – what happens to these? Do they get kept or returned to Health Canada?

For program funding in the Set funding model (for example, Non-Insured Health Benefits Medical Transportation), surplus funds attributed prior to the September 30, 2013 date are returned to the Receiver General of Canada; surplus Set funds after the Novation date are returned to the FNHA to be re-invested in BC on health program activities. Program funding in the community flexible transfer and block funding contribution agreements are carried over in the usual fashion with no changes and are not impacted by the October 1 transfer date.

28. Fiduciary Duty – what is the arrangement? Is this related to Rights or Treaty?

This arrangement is "administrative", and thus has no impact on treaty rights and is silent on Fiduciary Duty. Prior to signing the Framework Agreement the FNHC sought and received an independent legal opinion which clearly states that the Framework Agreement does not impact the federal fiduciary duty. In addition, Section 3.1 of the Framework Agreement contains a No Prejudice clauses pertaining to Aboriginal Rights and Treaty Rights, etc.

29. If a contribution agreement is terminated by Canada, what recipient obligations remain?

If Health Canada terminates a contribution agreement, the recipient is required (as per the terms and conditions of the agreement) to provide a final financial report or audit and a final program activity report within 90 days of the termination date. The Recipient is also required to pay any amount owing to the Crown. This is a common clause within all agreements.

30. What is the legal entity and the accountability to my village?

The First Nations Health Authority is governed by an operating Board of Directors providing leadership and oversight for all corporate operational activities of the organization and combines years of experience in First Nations health, community development, financial management and political expertise at all levels of government. The FNHA is accountable to its members. The members of the FNHA are the 15 members of the First Nations Health Council who are elected by the Chiefs of each region.

31. Does the FNHA have a "Treasury Board" for communities that run short of funds?

The FNHA does not have a Treasury Board and will need to manage within its budget for NIHB, contribution agreements and regional operations. Contingency planning is part of the budget process. It is important to note that, due to the funding commitments established in the Framework Agreement, BC has been insulated from the budget cuts made to other regions and from the sunsetting of specific programs. As with the other Health Authorities in BC and Canada there will never be enough funding for health care. Instead of Health Canada determining our budget, the FNHA has this responsibility and our collective objective is to do a better job for our citizens, including building budget discussions into our engagement activities. The Tripartite partners are committed to making this work, while the FNHA has a set budget, in the event of unforeseen disasters like pandemics, we will be supported by our partners.

32. We want an environment where Health Canada and the FNHA work together with communities who are stepping out of or joining existing health service groups. Will the current processes continue?
Health Canada has processes in place for those wishing to join existing groups and those wishing to step away (disengagement). These processes and policies will continue for a minimum of two years. During Transformation we have an opportunity to revisit these guidelines to have the greatest impact on our First Nations population health and wellbeing, including new ways to do business in a cost-effective manner which reflects the Community Driven Nation Based directive.

33. Are First Nations able to negotiate the terms of novation for their protection?

The Three Party Novation agreement is an administrative agreement that has been developed jointly by the FNHA and Health Canada to protect everyone's interests. The recommendations from First Nations communities received through the regional sessions have been considered and incorporated.

34. Were there minutes of these Novation sessions taken and will they be distributed?

Minutes were not taken at the Novation presentation sessions. The presentation deck and the draft Three Party Novation Agreement was circulated at each session. This document represents a summary of all the questions raised during the information sessions.

35. Non- Insured Health Benefits – will there be any process to look at re-basing of Patient Travel budget amounts in the contribution agreements? Expenditures continue to rise with specialist appointments, etc.

Medical Transportation is a demand-based program and there is a process to address Medical Transportation overages, dependent on budget availability. This process will continue through transition with the First Nations Health Authority. Please refer to your Program Coordinator and/or the Non-Insured Health Benefits Program for further assistance.

36. I don't understand why this is a Three Party Agreement.

The Novation Agreement creates the formal relationship between the FNHA and the contribution agreement recipient. It is a three party agreement as to secure the consent of all three parties in the transfer of the agreement from Health Canada to the FNHA.

37. What is the "downside" of not signing the Novation Agreement?

There are more than 200 contribution agreements in the BC Region and if the FNHA were required to prepare new agreements to take effect October 1, 2013, there could be delays in developing, issuing and making payments under these agreements. If a recipient chooses not to sign the Novation Agreement, Health Canada will terminate its existing agreement and the recipient will be required to prepare an audit and annual report (from April 1 to September 30) which will be due 90 days after termination date. The Three Party Novation Agreement is the most efficient, stream-lined and seamless process for all parties.

Any contribution agreement which has to be entered into between the FNHA and a recipient who has not signed the Novation Agreement, will have the same terms and conditions as the terminated agreement. Thus, it is to the benefit of the recipient and their community to sign the Novation Agreement and avoid any possible delays in payments.

38. Can we have a dedicated contribution agreement with our current health board, instead of the band?

A contribution agreement recipient may be a First Nations band, health society, tribal council or other legal entity. Please refer to your Program Coordinator for more information.

39. With respect to the contribution agreement, will everything carry over and be honoured by the FNHA (for example, surplus management?)

Response: Yes, all the existing terms and conditions of the agreements will carry over to the FNHA including all on-going program funding to March 31, 2015 and capacity for surplus management (Flexible and Block components of the agreements, but not for Set programs or funding models).

40. Can BC First Nations go back if we want to after this transfer to the FNHA?

Through the Framework Agreement, individual communities new relationship is with the FNHA as funder and governance partner as agreed to by leadership. Section 12 of the Framework Agreement clearly outlines the process to terminate the Agreement. FNHA operations have been designed to replace regional operations for Health Canada. If the Framework Agreement were terminated, FNHA operations would have to be dismantled systematically.

41. Will targeted programs and unionization be protected in this Novation process?

Response: The existing terms, conditions and flexibilities for the various funding agreements will continue to remain in effect following the transfer and novation. Those programs in the Set funding models will hold the same rules as we have now, but after the transfer to the FNHA, any surplus funds will go to the FNHA, not Health Canada. All Health Canada public servants are unionized – There are collective agreements that will transfer from Health Canada to the FNHA and those discussions are underway now.

42. We are in discussions with Health Canada with respect to moving into a higher funding model, how will this work with this transfer process, especially as our current agreement will now be extended another year to March 31, 2015?

The same principles will continue to apply to communities moving forward into higher level funding agreements. Work and Health Plan development activities will be on-going subject to available resources.

43. We have no Health Director – how do I fund a Health Director position within my contribution agreement?

The Set funding model allows for agreement recipients to draw an administration (%) cost from all program funding provided to help support the cost of administration. Once a recipient moves into a higher funding model, there are incremental funds to assist with the cost for a Health Director.

44. After the transfer, who will own the health buildings on Reserve and be responsible for them?

The current buildings On Reserve are listed in either the recipient contribution agreement or are operated directly by Health Canada. After the transfer, the FNHA will assume this role. The Crown has legal title to reserve lands and holds them for the use and benefit of First Nations; First Nation health Facilities located on these lands are under the control of the BC First Nations or First Nation Health Providers , and will not be transferred to the FNHA under this Agreement. O and M capital and repair funding will continue in the same format, and the requirements will remain.

45. Who is updating our band members Off Reserve?

The FNHA, FNHC and regional health authorities are at different stages of developing their respective Urban Strategies in order to incorporate the needs of First Nations living away from home.

46. In November there was a court decision which involves reinstatement of status for some non-status First Nations, which will impact on numbers accessing health programs and services. Is there coverage for this in the Framework Agreement?
Yes, the Contribution Funding Agreement between Health Canada and the FNHA has a clause that accounts for this: "…in the event that Canada introduces expanded beneficiary eligibility and associated funding for any federal health programs and services set out in Schedule 3 as a result of possible legislative amendments to the Indian Act (Canada) or decisions of the courts that result in an increased number of persons eligible to be registered as an Indian under that Act, Canada and the FNHA will work together to determine impacts and approaches to address such change. 

47. We have an agreement that expires March 31, 2014 – can we develop a new agreement when it expires?

All current contribution agreements will be extended to March 31, 2015 to allow for a smooth and seamless transition to the FNHA. The FNHA will renew and issue contribution agreements when these expire.

48. The audit breakdown you refer to in the Three Party Novation Agreement could be an additional cost to recipients – will there be any guidance on this?

Yes, a guidance document will be provided to assist recipients and their auditors in the preparation of the 2013/14 fiscal year financial reporting/audit and additional audit costs. With respect to reporting, business will be conducted as usual, one report will be issued by the community at year end. This report will be broken into two reporting periods April 2013- September 2013, and October 2013-March 31, 2014. All reconciliation will occur in the background between Health Canada and FNHA with no inconvenience to the community.

49. We are interested in getting our own legal opinion on this Three Party Novation Agreement – will Health Canada assist us in funding this activity?

No, Health Canada will not provide additional funds for this purpose. The Three Party Novation agreement has been reviewed at length by both FNHA and Health Canada legal counsel. Feedback from the Regional Novation sessions has been considered and incorporated in the final draft.

50. When will the staff at Health Canada get their Reasonable Job Offers (RJO's) and if they don't accept, is there a buyout and if so, who pays?

The RJOs will be issued once the Canada Funding Agreement with the FNHA is signed. Canada has collective agreements with staff that set out items such as whether or not severance or termination pay applies. Canada, not the FNHA, is responsible to pay for these expenses.

51. To whom does the FNHC board report to? How does the structure work?

The First Nations Health Council reports to their respective regions and sub-regions. Please visit the FNHC Terms of reference for a detailed breakdown of FNHC accountabilities. The First Nations Health Authority Board of Directors reports to the members of the FNHA. The members of the FNHA are the First Nations Health Council members.

52. We are in the Evaluation process for our current Transfer agreement. Do we proceed with this activity in light of the impending transfer? In addition, do we continue with the similar reporting activities using the Community Based Reporting Template?

Response: Yes, terms and conditions of the agreements remain the same for at least a two year period, including the evaluation and other reporting requirements. It is anticipated that activities in preparation for Transformation will greatly improve reporting requirements.