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

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