First Nations Health Authority: Transforming a public health perspective. Presented by Dr. Shannon Waters & Dr. Naomi Dove
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1 First Nations Health Authority: Transforming a public health perspective Presented by Dr. Shannon Waters & Dr. Naomi Dove Canadian College of Health Leaders Vancouver Island chapter event April 10,
2 Overview Transition to the First Nations Health Authority Timeline to transition & beyond Governance Regionalized structures & planning Vancouver Island Partnership Regional Health & Wellness Planning Public health & the medical officer role Senior Medical Officer workplan Health Promotion Programs Leading to transformation 2
3 Transition Planning Stages 3
4 Our Common Foundation Our Vision Healthy, self-determining & vibrant, BC First Nations children, families & communities Our Values Respect, Discipline, Relationships, Culture, Excellence & Fairness Our Directives 1. Community Driven, Nation Based 2. Increase First Nations Decision- Making 3. Improve Services 4. Foster Meaningful Collaboration & Partnerships 5. Develop Human & Economic Capacity 6. Be without Prejudice to First Nations Interests 7. Function at a High Operational Standard 4
5 The FNHA Mission Statement: (approved by the Board on January 31, 2013): "The FNHA supports BC First Nations individuals, families & communities to achieve & enjoy the highest level of health & wellness by: working with them on their health & wellness journeys; honouring traditions & cultures; & championing First Nations health & wellness within the FNHA organization & with all of our partners. 5
6 First Nations Health Authority 6
7 Regional Work
8 Vancouver Island Approach
9 Vancouver Island Partnership Accord Improve the health outcomes for First Nations in the creation of a more integrated, culturally appropriate, safe, & effective health system.
10
11 Partnership Development Implement the broad goals of the Partnership Accord through a partnership driven, project specific work plan & ongoing relationship development. 11
12 Regional Health & Wellness Plan Mental Wellness Maternal Child & Family Health Primary & Community Care Public & Population Health Health Benefits 12
13 Mental Wellness & Substance Use Regional Planning & Action Cultural Safety Cultural programming as foundation of wellness Social determinants of health Working collaboratively with partners (e.g. Island Health, Ministry of Education, MCFD, Ministry of Justice) Integration of traditional/cultural & biomedical approaches Coordination of care, discharge planning, aftercare, follow-up & support 13
14 Transforming a public health perspective... 14
15 Determinants of Aboriginal Health Proximal Intermediate Distal Health Behaviours Health Care Systems Colonialism Physical Environments Educational Systems Racism & Social Exclusion Employment & Income Community Infrastructure & Resources Self-determination Education Environmental Stewardship Food Insecurity Cultural Continuity National Collaborating Centre for Aboriginal Health; Health Inequalities & Social Determinants of Aboriginal People s Health,
16 The First Nations Perspective on Wellness A visual expression to the First Nations Perspective on Wellness the way it has always been. Passed down from our Elders & traditional healers. Wellness belongs to every human being & their reflection of this Perspective will be unique; in the same way an individual has their own Wellness, so can a larger organization & its departments 16
17 Aligning Public Health with the Wellness Approach 17
18 VP Health Services VP Corporate Services VP Policy Planning & Strategic Services VP First Nations Health Benefits Chief Executive Officer Acting Senior Medical Officer VP Information, Innovation & Management Services, CIO VP Human Resources VP Finance, CFO 18
19 HEALTH SERVICES TODAY Nursing - Public Health Services -Treatment Services in remote & isolated communities - Home & Community Care -Training & Development -Recruitment & Retention -Transfer Nursing Support & functional supervision Health Surveillance -Collect, analyze, interpret & report on First Nations data Health Promotion & Disease & Injury Prevention -Mental wellness NNADAP, IRS Community Crisis intervention -Children s Programs - ECD, AHS, prenatal nutrition, FAS/FAE, Maternal & Child Health -Chronic disease (including Diabetes) & - Injury Prevention Environmental Health Services -Delivery of Environmental public health services including: Drinking Water, Contaminant Research, Community Emergencies Health Protection -Immunization -Pandemic/Emergency preparedness planning -Prevention & treatment of communicable diseases -HIV/AIDS
20 HEALTH SERVICES 2 YEARS FROM NOW TRANSFORMATION OFFICE OF CHIEF NURSING OFFICER Within this office the team will continue & build on current nursing services. OFFICE OF CHIEF/SENIOR MEDICAL OFFICER Moving from program management to building on content expertise to support communities design & deliver programs & services meeting their community needs. Creating Emergency Coordinator Position better support for communities in crisis Health Services evolves - with 2 pillars within FNHA Senior Executive Team: Chief Nursing Officer & Chief Medical Officer
21 What is a medical health officer? Training & Background Competencies: Foundational Clinical Competencies Monitoring & Assessing the Health of the Public Public Health Consultant Investigating & Mitigating Immediate Risks to Human Health Policy, Planning & Program Development Communication, Collaboration & Advocacy for the Public s Health Leadership & Management Professional Practice A Set of Minimum Competencies for Medical Officers of Health in Canada Final Report (2009) 21
22 FNHA Physicians: Principles Cultural competence & safety Community driven, nation based Collaboration Prioritization of First Nations interests Consistency Accountability Data Stewardship Flexibility Comprehensiveness Stability From discussion amongst FNHA physicians 22
23 Deputy FN Provincial Health Officer Provides leadership & expert medical advice, support & guidance regarding Aboriginal health, policy development, & programs/services/initiatives; Reports on the status of Aboriginal & First Nations health; & Assists in the development of the (BC) First Nations Health Authority. 23
24 Mental Wellness Senior Medical Officer Workplan Priorities Short-term/Weeks: protocol for mental health crisis response in communities Medium term/months: changing funding requirements for crisis funding Longer term/year: developing mental wellness strategy for the FNHA 24
25 Supporting mental wellness & suicide prevention in communities 25
26 26
27 Traditional Wellness Incorporating traditional healing practices into health programs & services for First Nations people Internal advice paper from the FNHA Physician s Advisory Group 27
28 Public Health & Primary Care Strategy Cancer strategy Cardiac strategy Very similar in terms of content but partnerships that are leveraged are different 28
29 FNHA Medical Officer Portfolios Health Surveillance Baseline health assessment & surveillance Wellness reporting Emergency preparedness & response Communicable disease Health Protection Health Promotion Disease & injury prevention Effective practices Community capacity 29
30 Health Programs Transformation 30
31 FNHA Health Promotion Programs Health Prevention & Promotion Directorate Early Childhood Development Mental Health & Addictions Injury Prevention & Chronic Disease Aboriginal Head Start Indian Residential Schools Aboriginal Diabetes Initiative Maternal Child Health National Aboriginal Youth Suicide Prevention Strategy Injury Prevention Fetal Alcohol Spectrum Disorder National Native Alcohol & Drug Abuse Program Canada Prenatal Nutrition Program 31
32
33 Healthy Child Development Maternal Child Health (preconception to early childhood) Preconception / Fetal Alcohol Spectrum Disorder Program (preconception to early childhood) Canada Prenatal Nutrition Program (prenatal to early childhood) Aboriginal Head Start On Reserve Program (birth 6 Years) Children s Oral Health Initiative (birth - 7 years) Prenatal Birth Postnatal Early Childhood
34 Maternal, Child & Family Health Strategic Approach Strategic Directions 1. Meaningful collaborative planning, knowledge sharing & timely & consistent communication occurs with/for First Nations & Aboriginal communities 2. Increase First Nations & Aboriginal community control & leadership in collecting information & monitoring trends in maternal, child & family health 3. Develop a culturally competent workforce, culturally safe services & culturally appropriate resources in maternal, child & family health 4. Improve access to continuous & well-connected services & resources across prepregnancy planning, pregnancy, birthing & post-birth care for First Nations & Aboriginal mothers, children & families 5. Promote holistic pre-pregnancy planning, pregnancy, birthing & post-birth health & wellness for First Nations & Aboriginal mothers, children & families 6. Promote & support early childhood development & safe environments for First Nations & Aboriginal infants, children & families
35 FNHA Mental Health & Wellness Programs (Vancouver Island) National Native Aboriginal Drug & Alcohol Program (NNADAP) Community based funding 17 communities Residential Treatment Centres Kackaammin Family Development Centre Namgis Treatment Centre Tsow-Tun Le Lum Indian Residential Schools (IRS) Resolution Health Supports Program Nuu-chah-nulth Tribal Council Tsow-Tun Le Lum National Aboriginal Youth Suicide Prevention Strategy (NAYSPS) 3 teams in Vancouver Island region 35
36 National Aboriginal Youth Suicide Prevention Strategy (NAYSPS) Target population: First Nations youth on-reserve ages yrs Goal: reduce risk factors & promote protective factors Program elements Range of activities ASCIRT teams Community based projects Support to communities Postvention Prevention Intervention 36
37 Aboriginal Suicide Critical Incident Response Team (ASCIRT) Inter-Tribal Health Authority ASCIRT (Serving 29 communities) Nuu chah nulth Tribal Council Huu-pee-stalth (Serving 14 Communities) Cowichan Tribes ASCIRT (Serving 6 communities) 37
38 The Path to Transformation What is the goal? Effective, wellness based programs responsive to selfidentified community priorities How do we get there? Community engagement & dialogue Holistic program framework development Epidemiology Risk & protective factors Effective prevention interventions, best practices Based on culture Evaluation Environmental scan mapping programs & services Gaps & opportunities Alignment & coordination 38
39 Working with Health Authorities Attendance at PHO/CMHO teleconferences Meet with CMHOs in regional health authorities Meet with PHSA agencies 39
40 Moving forward... Holistic view of health Culture is the foundation Focus on determinants of health Focus on community based, locally relevant approaches Build on existing strengths & assets Use multiple complementary strategies to promote health at the individual/community level Partnerships & collaboration 40
41 Vancouver Island Region CHARTING OUR PATH TO WELLNESS TOGETHER Huy tseep q u Hiskwe Gila kasla Kleco Kleco Thank you
42 Thank You! Questions & Discussions Dr. Shannon Waters MD MHSc FRCPC Acting Senior Medical Officer Phone: Dr. Naomi Dove MD MPH FRCPC Public Health Physician, Health Promotion & Prevention Phone:
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