FAQs

In response to feedback from First Nations Chiefs, leaders and communities, the FNHC arranged for focused engagement during 2023 to 2025 to discuss a BC-specific approach to First Nations health legislation. This new First Nations-led effort, separate from federal or provincial initiatives, is aiming to inform federal and provincial laws from a BC-specific First Nations perspective. Engagement will reflect feedback and priorities given by First Nations during past discussions on this topic, and consider the First Nations Health Governance Structure and legal tripartite health partnership with BC and Canada.

In January 2021 Indigenous Services Canada (ISC) began a cross-country process to co-develop federal distinctions-based Indigenous health legislation. The ISC-led and FNHC-facilitated dialogue on this topic occurred in 2021 and 2022. During that time it became clear that not all BC-specific concerns fit within the federal legislative (law-making) process. For example, ISC’s process did not consider the First Nations Health Governance Structure in BC, nor allow enough time for meaningful dialogue on this highly complex, impactful topic at the grassroots level (as per Directive #1 and #4). In response, the FNHC submitted a letter to ISC in 2022 emphasizing the need for a separate process to address BC-specific concerns.

With more time to meaningfully engage, the goal is to develop a BC-specific ‘Principles Document’ to guide provincial and federal legislation. Solely produced by First Nations in BC, this could outline how First Nations in BC want to be acknowledged and included in both federal and provincial legislation processes and their interests reflected in future amendments to legislation. This independent effort has the potential to embed First Nations’-specific priorities into the provincial health system as per the 10-Year Strategy.

A ‘Principles Document’ can describe important considerations, such as for working with First Nations in BC, including culture, language, traditional knowledge, self-determination, as well as commit governments to identified principles, such as those that flow from First Nations, traditional, hereditary and family laws and legal orders. Examples, or standards to consider, include the Canada Health Partnership Accord.pdf and the 7 Directives.

Unlike other discussions to date on this topic, IN SCOPE engagement activities will involve:

• Focused conversations on high-level principles;
• Discussions on BC-specific health system-wide goals; and
• Dialogue on high-level systems change, including, but not limited to, funding and working with provincial health partners.   

Examples of OUT OF SCOPE activities include discussions on ISC’s federal distinctions-based Indigenous health legislation (although the door remains open for alignment with this work) and individual programs and services.

To date, Chiefs and leaders have highlighted the following strategic opportunities:

• Embedding direction provided through the 10-Year Strategy. 
• Whether to enshrine the First Nations Health Governance Structure into law.
• Bolstering community-driven, Nation-based processes that respect First Nations autonomy and decision-making on health and wellness. 
• Enshrining anti-racism within the health system. 
• Enshrining the 7 Directives and vision of healthy, self-determining, vibrant BC First Nations children, families and communities into law.
• Moving forward on UNDRIP within health in BC.

Potential FNHA service-related opportunities and implications include:

• Legislating or strengthening the authority of the FNHA CMO, including Environmental Health officers.
• Environmental health, including drinking water advisories, safety and environmental public health services. 
• Emergency management (e.g., wildfire response; local-level operations). 
• Health data governance (e.g., structures and processes by which First Nations in BC can access First Nations’ health data). 

At spring and fall 2024 Regional Caucus, the planned dialogue will recap and gather learnings from Chiefs, leaders and communities to inform the development of a BC-specific First Nations health legislation ‘Principles Document’ for review at spring 2025 Regional Caucus. Regions will also discuss a BC-specific approach to First Nations health legislation during fall 2024 sub-regional and Nation-based sessions, including revisiting early priorities derived from past discussions. This engagement will end at Gathering Wisdom XIII in June 2025 with the consideration of a ‘Principles Document’-type consensus paper.

The Canada Funding Agreement 2023/24 – 2032/33 (CFA) is now signed (see News Release | Canada Announces New $8.2 Billion Funding Agreement with FNHA | First Nations Health Council (fnhc.ca)). This legal agreement sets out terms for FNHA funding with ISC over the coming decade. This will help to ensure the funding needed to advance important ongoing community and regional level work, within the FNHA’s central service functions.