FNHC Infobulletin Volume 1 Issue 3 | October 2008 - First Nations ...

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First Nations Health Council | October 2008 Infobulletin | page 4Community Spotlight: Ktunaxa First NationAbout the Ktunaxa NationKtunaxa citizenship is comprised of Nationmembers from seven Bands located throughouthistoric traditional Ktunaxa territory. FiveBands are located in British Columbia, Canadaand two are in the United States. ManyKtunaxa citizens also live in urban and ruralareas “off reserve”. Ktunaxa (pronounced‘k-too-nah-ha’) people have occupied the landsadjacent to the Kootenay and Columbia Riversand the Arrow Lakes of British Columbia,Canada for more than 10,000 years. In totalthe Ktunaxa Nation is comprised of approximately5,000 individuals, though a census tobe carried out next year will clarify this numberfurther.Creating a Governance ModelThe Ktunaxa Nation is putting governancefirst. Over the past 9 years the Ktunaxa havedeveloped a governance model that combinestraditional governing structures, indigenouspedagogy, and fiscally accountable checksand balances. The model was developed overa decade through a grassroots process ofcommunity meetings, focus groups and sectorspecific workshops.“At the time that we entered the treatyprocess we did two things,” comments GwenPhillips, Governance Transition Coordinator,“we committed to exercising personal andgeographic jurisdiction over our land and ourpeople, and at the same time committed to acommunity development agenda.” A communitydevelopment agenda commits us toconsulting with our citizens and acting upontheir recommendations on a consistent andfrequent basis. We havewhat we refer to as acitizen-driven processthat guides our treaty negotiations.The existingCouncils direct governancetransition, basedon the people’s agenda.The cornerstone of thisagenda is the notion that“you can only move as fast as the people.”The Ktunaxa have organized their nation into 5sectors including: Social Investment, TraditionalKnowledge, Corporate Services, Land &Resource Stewardship, and Economic Development& Investment Planning. Each sector isgoverned by a sector specific council composedof individuals with expertise that sectorarea. The role of the sector council is to “Providestrategic direction for government.” Inthe future, each sector councilwill be governed by a Chief whohas experience and expertise intheir given area. This model, 9years in the making is currentlybeing adopted by the Ktunaxa.A Ktunaxa constitution is alsoin the works and is expected tobe completed next year. Whenasked why the Ktunaxa have focusedso strongly on governanceGwen comments: “I think for usthe important thing is to knowyour limits. You set the outmostboundaries for what you can doas a nation and to know wherethose boundaries are. You don’thave to exercise jurisdictionin all of those areas, but it is ahuge learning opportunity tofind out where those limits lay.Then you have choice.”“We have what we refer to as a citizen-driven process thatguides our treaty negotiations. The existing Councils directgovernance transition, based on the people’s agenda. Thecornerstone of this agenda is the notion that “you can onlymove as fast as the people.”The Ktunaxa NationSocial SectorAn important step in building agovernance model is establishingthe core ideas/principlesthat your government willadhere to and promote. Theseideas, also serve to define the populations thatyou intend to serve. Early on in the process theKtunaxa developed the following guiding principlesfor the delivery of Aboriginal health andwellness services by the Ktunaxa government:• Authority for health planning in the KtunaxaTraditional Territory and the associated administrationof resources will rest with the KtunaxaNation.• The interests of all Aboriginal people wholive in Ktunaxa Territory will be represented inall (regional) Health Planning sessions.• All Aboriginal people will be eligible to accessthe same level of services regardless of statusor residency.• Common Aboriginal values will be integratedinto planning and service delivery.• All Aboriginal people of this area will worktogether, nurturing and celebrating our commonidentity.Through the development of these principles,the Ktunaxa define their role as being responsiblefor health planning for all Aboriginalpeople within their traditional territory. Asthere are no friendship centres and very fewAboriginal organizationswithin the Ktunaxaterritory, the Nation hasmade a commitmentto ensuring that theinterests of all Aboriginalpeople are includedin their processes.Seats have been madeavailable on KtunaxaBoards and committees for Métis and Urbanrepresentatives, as required. When planning,special sessions have been held in keylocations throughout their territory, to permitoff-reserve Aboriginal people to participate.PartnershipsCollaboration and Partnerships are necessaryingredients in the delivery of quality healthcare, especially for many small First Nations.The Ktunaxa are currently concluding a Letter
First Nations Health Council | October 2008 Infobulletin | page 5Putting Governance Firstof Understanding LOU with Interior HealthAuthority that sets out an administrative arrangementfor the two parties. “We have justabout concluded our LOU with IH. Through thisprocess we determined that two levels of relationshipdocuments were required,” says Phillips,“The nature of IH’s authority is delegatedauthority of the crown. We are negotiating aletter of understanding with IH as an agent ofthe crown, and a service delivery body, andthen we will negotiate an MOU with Provincethemselves on the jurisdiction side.”can’t run a hospital, but we can put in placepatient navigators to making those hospitalstays a lot better for our people.”The VisionWith rural school and hospital closures becomingthe norm, health service delivery for“I think for us the important thing is to know your limits. You setthe outmost boundaries for what you can do as a nation and to knowwhere those boundaries are. You don’t have to exercise jurisdictionin all of those areas, but it is a huge learning opportunity to find outwhere those limits lay. Then you have choice.”rural and remote citizens, both Aboriginal andnon-Aboriginal is becoming a major concern.Patient travel already consumes 50% of mostFirst Nations Health budgets, and the travelinvolved can be tiring and stressful for bothpatient and family. The Ktunaxa are looking atways of bringing health service delivery closerto home through integration and co-locationof services across the Ktunaxa territory. TheKtunaxa recently met with the Deputy Ministerof Children and Families who agreed thather ministry must find a new way of funding,to reflect the Ktunaxa’s authority as a Nation,to provide child and family services to theircitizens and other Aboriginal people who maketheir home within Ktunaxa territory.Overall, the Ktunaxa have set their sights onplaying a large role in health service delivery inthe future, not only for Ktunaxa people, but fornon-Aboriginal residents as well. “First Nationspeople aren’t going anywhere.” states Phillips“the provision of rural health services belongswith us, we are the stable, and growingpopulation in every rural region across BritishColumbia.”Purpose of Ktunaxa/IH LOU• To develop and implement a regionalhealth plan• To look at policy for the allocation ofresources• To administer and allocate grants forhealth services in the region• To develop and implement regionalstandards• To monitor and evaluate provincial andregional standardsWith health care currently consuming aroundone third of BC’s annual budget, economiesof scale are always considered in programdevelopment and budget allocations. “Wedon’t have a lot of money and we are not goingto have a lot of money as a self governingnation. When you look at governance thereare costs attached, administrative costs, andenforcement costs. We are trying to figureout just what it is that we will need to havejurisdiction over, in order to meet our needs.We don’t need to have law-making authorityover everything; only those things where ourinterests won’t be met under someone else’sjurisdiction. We see co-management agreementsbeing very important to us. What weneed is to come to a place where those largersystems respect who we are, and our history inour ancestral homelands, where they becomewilling to relinquish controls in those areasthat need to be under our control because werequire that authority and can do it better. We
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