2012-2013

ATLANTIC POLICY CONGRESS OF FIRST NATIONS

CHIEFS SECRETARIAT

MI’KMAQ MALISEET ATLANTIC HEALTH BOARD ANNUAL REPORT

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TABLE OF CONTENTS

MMAHB Meetings Page Number 1. June 19, 2012 a) Agenda 03 b) Meeting Notes 04 2. October 18, 2012 a) Agenda 10 b) Meeting Notes 11 3. January 15, 2013 a) Agenda 17 b) Meeting Notes 19 4. Special MMAHB Meetings (2) a) October-November 2012 33 b) March 2013 39 Health Tech Meetings 1. June 2012 c) Agenda 51 d) Meeting Notes 52 2. October 2012 c) Agenda 55 d) Meeting Notes 56 3. January 2013 a) Agenda No Agenda b) Meeting Notes 57 Co-Chairs Meetings 1. June 2012 a) Agenda 58 b) Meeting Notes 59 2. October 2012 a) Agenda 61 b) Meeting Notes 62 3. January 2013 a) Agenda No Agenda b) Meeting Notes 64 Primary Health/NIHB Committee Meeting 1. May 2012 a) Agenda 66 b) Meeting Notes 67 2. September 2012 a) Agenda 72 b) Meeting Notes 73 3. December 2012 a) Agenda/Meeting Notes 76 b) Agenda/Meeting Notes 78 C&Y/Public Health & Primary Care Committee 1. June 2012 a) Agenda 81 b) Meeting Notes 83

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2. September 2012 a) Agenda 88 b) Meeting Notes 90 3. December 2012 a) Agenda 98 b) Meeting Notes 100 Wellness/Mental Wellness Committee 1. May 2012 a) Agenda 103 b) Meeting Notes 104 2. September a) Agenda 108 b) Meeting Notes 109 3. January a) Agenda 117 b) Meeting Notes 119 MMAHB Coordinator Job Description 122 MMAHB Coordinator Work Plan 2011-2012 125

Note on the Content:

The New Terms of Reference were accepted by the MMAHB and Atlantic All Chiefs in September 2012. The MMAHB structure was altered and is reflected in the content of this report. For example, the Primary Health Care and Public Health Committee is now the Public Health and Primary Care Committee and has absorbed the former Child and Youth Committee. There is also now a Non-Insured Health Benefits Committee. For more information on the new structure please see the APCFNC Website under Health/MMAHB www.apcfnc.ca

For the Health Technicians portion where it says No Agenda the reason is that the new structure was the only topic, Therefore there was no need of a formal agenda.

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MMAHB AGENDA

Tuesday June 19, 2012 at the Crowne Plaza, Moncton

9:30am-4:00pm

Coffee and Networking 9:30 Opening Prayer (Elder) Introductions, Approval of Agenda & Minutes (Chairperson) 10:00 Note: Distribute MMAHB committee member list. Acknowledgement of Standing Written Reports (Chairperson) 10:15 The following standing reports requested by MMAHB are: Heath Services Integration Fund, Aboriginal Health Human Resources Initiative, Contribution Agreement Funding, Health Information Management (ie. Panorama, Tele- health, Surveillance Capacity Project). Regional Roundtable (MMAHB Chiefs, response from FNIHB RD) 10:20 MMAHB Subcommittee Reports (Subcommittee Co-Chairs) 11:00 Co-chairs of the 3 sub-committees provide a verbal report of key issues, accomplishments or direction sought in 5 minutes with 5 min for questions. Update on 2012-13 budget and organizational change (Debra) 11:30 The RD will share budget information, speak to reductions, and comment on organizational changes affecting HQ and Regional functions & accountability. Lunch 12:15 2011-12 Financial Information (Frank) 1:00 In response to MMAHB requests, FNIHB will present year end actuals for its programs that pertain to mental health, addictions, and elder care. FNIHB will provide information specific to the implementation of the strategic action plans in these areas. 2011-12 Financial and Utilization Information on NIHB (Louise) 1:20 In response to MMAHB requests, FNIHB will present year end actuals on utilization and cost by benefit category. This will be shown for the region as well as the McIvor clients and Qalipu clients. Implications of the Financial Transparency Act (Kandace) 1:40 Kandace Terris will share what she knows about possible implications of the proposed legislation on health funding and First Nations reporting. Proposed Terms of Reference – MMAHB & NIHB Committee 1:45 The MMAHB Evaluation Steering Committee will present proposed ToR for MMAHB and a new MMAHB Committee on NIHB. This is a discussion item. Finalization will happen at the fall MMAHB. Next Meeting (date and location) 3:00 Closing Prayer

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MMAHB Meeting June 19, 2012 Crowne Plaza, Moncton N.B.

MMAHB Members Present:

Attendees: Representing: Attendees: Representing: Voting members: Chief Candice Paul APC NB Co-Chair Debra Keays-White FNIHB Chief Deborah Robinson APC NS Co-Chair Christiane Poulin FNIHB Chief Brian Francis MCPEI Louise Cholock FNIHB Proxy Chief Dominic Denny CMM Agatha Hopkins FNIHB Proxy Claudia Simon MAWIW Tryna Booth FNIHB Proxy John Frank Toney UNSI Proxy Brenda Roos FNIHB Proxy Frank Fleet FNIHB Non-voting members: Elder John Joe Sark APC Elder James McGrath C&Y Co-Chair Christine Gabriel APC Elder Sally Johnson C&Y Co-Chair Laurie Nicholas PHC/PH Co-Chair Janet Pothier Wellness Co-Chair Susan Ross PHC/PH Co-Chair

MMAHB Members Absent:

Vice Chief Roger Augustine AFN Chief Mi’sel Joe Miawpukek Vice Chief Morley Googoo AFN Chief George Ginnish UNBI Grand Chief Ben Sylliboy Mi’kmaq Nation Chief Aaron Sock MAWIW Leila Gillis FNIHB Chief Leroy Deny UNSI Jim Millar FNIHB Chief Andrea Paul CMM Kandace Terris FNIHB

Guests/Observers Present:

Amanda Peters APC Wade Were FNIHB

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Chelsea Googoo APC Peter Birney UNBI Loraine Etter APC Roseanne Sark MCPEI Chief Darlene Bernard MCPEI Peter McGregor FNIHB

Opening Prayer: Elder John Joe Sark

1.) Introductions, Approval of Agenda and Minutes: Chief Candice Paul:

- Minutes approved by consensus by the committee. - Approval of Agenda: Debra Keays White and Tryna Booth.

2.) Acknowledgement of Standing Written Reports: Chief Candice Paul

3.) Regional Roundtable (MMAHB Chiefs, response from FNIHB):

UNSI Proxy John F. Toney: no report

MCPEI Chief Brian Francis: The Chief expressed two concerns: 1) the Budget 2012 federal funding reductions, and 2) the number of PEI First Nations residents prescribed methadone. As per Action Item #6 in the MMAHB March minutes, Debra Keays-White noted FNIHB (Dr. Bailey) had committed to prepare an analysis of methadone use by community/province for MMAHB. FNIHB will aim to have this available for MMAHB’s next meeting.

MAWIW Proxy Claudia Simon: no report

Chief Deborah Robinson: The Chief expressed a concern regarding the regulation of marijuana growing operations on reserve, and the environmental health impacts. Debra Keays-White will contact the appropriate Health Canada authorities regarding the growing of medicinal marijuana and prepare a briefing. She will also have FNIHB’s Regional EHO to report to her on environmental health impacts.

Action Item #1: Debra Keays-White will provide a briefing on the federal regulations and potential environmental health impacts of FN residents growing medicinal marijuana on reserve.

APC Co-Chair Chief Candice Paul: The Chief expressed strongly her concern regarding the Budget 2012 federal funding reductions that affect First Nations organizations. She urged MMAHB Chiefs to take collective action with the AFN by sending a clear message to the Prime Minister regarding First Nations opposition to these reductions.

Action #2: APC will organize a discussion among MMAHB Chiefs to discuss the impacts of the federal funding reductions in an in-camera session after the MMAHB meeting.

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CMM Proxy Dominic Denny: Mr. Denny asked Janet Pothier to voice CMMs concerns. Janet expressed concerns regarding the Budget 2012 federal funding reductions to First Nations organizations. She raised a fear that First Nations will continue to face more funding reductions in subsequent years. She agreed to continue to discuss this matter in a separate session with MMAHB Chiefs after the MMAHB Meeting.

4.) MMAHB Committee Reports:

A.) Wellness Committee:

Janet Pothier referred to the Committee’s written report in the MMAHB meeting package. Janet highlighted the successful “No Harm in Trying” conference. A conference report is also found in the MMAHB meeting package.

Janet mentioned that the Committee is without a FNIHB Co-chair since Charmane Kaye’s retirement. Debra Keays-White indicated that Charmane would be able to remain as the Wellness Co-Chair since she is doing a casual placement with FNIHB carrying the Indian Residential Schools Health Support Program (IRSHSP) file.

Janet raised a concern that Brighter Futures-Building Healthy Communities (BF-BHC) funding may be reduced or eliminated. She also expressed a concern with the sun- setting of the IRSHSP funding. Debra also stated that she did not believe that the IRSHSP funding would end March 2013. She will ask Charmane Kaye to keep the Wellness Committee up to date as more is known about IRSHSP funding post 2012-13. Debra stated that she was not aware of any planned reductions in the BF-BHC area. In fact, FNIHB has specifically highlighted support for a continuum of mental wellness programs and services as a key area in its national strategic plan.

Action Item #3: Debra agreed to confirm her understanding about the BF-BHC funding and communicate the same to Janet in writing.

Janet indicated that the new illicit drug called “Bath Salts” is becoming a concern for First Nations as it is extremely dangerous. FNIHB commended Pictou Landing First Nation for its work with its local DHA on addressing this new concern.

Action Item #4: Dr. Poulin stated that she would provide the Wellness Committee information on Bath Salts from the Canadian Centre for Substance Abuse.

Chief Candace Paul stated the use of methadone is increasing and mental health counselling should be available for those taking it. Roseanne Sark raised a concern that NNADAP treatment centres do not admit individuals on methadone. Dr. Poulin stated that FNIHB is encouraging change through its NNADAP Modernization Framework, however, treatment centres are operated by boards of directors comprised of First Nations Chiefs. Chief Robinson noted that treatment centre staff qualifications and compensation are also related issues. Debra suggested that MMAHB should invite the

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Regional Addictions Partnership Committee and the NNADAP Treatment Centres to a MMAHB meeting to present their admission policies and programs, followed by a discussion of addictions needs and possible approaches to addressing these gaps.

Action Item #5: Amanda Peters will work with the Wellness Committee to organize a special session on addictions treatment involving MMAHB and representatives from RAPC and the NNADAP treatment centres.

B.) Child and Youth Committee:

James McGrath and Sally Johnson referred to their written report in the MMAHB meeting package. They highlighted that they would be presenting a recommended Strategic Action Plan to address the Chiefs’ Child and Youth priority in September as per the previously agreed to timeline.

The Co-Chairs described 4 options for the allocation of Fetal Alcohol Syndrome Disorder funding to Atlantic First Nations. Funding ends March 31, 2013, and a new 2 year allocation is available until March of 2015. Currently, 20 First Nations are served by 8 projects using a total of $467K in annual funding. The 4 options and recommendation were developed by the Committee. The Committee recommended continuing the current funding arrangements until March 31, 2015.

Decision: MMAHB accepted the Committee recommendation to maintain the status quo distribution of the FASD funding for two more years until March 31, 2015. Motioned by Chief Brian Francis. Seconded by Dominic Denny. Unanimously approved.

C.) Primary Health Care & Public Health Committee

Laurie Nicholas and Susan Ross referenced their written report in the MMAHB meeting package. No points were highlighted.

5.) Update on 2012-13 Budget and Organizational Change:

Debra Keays-White did not use a Powerpoint Presentation or have a written report. She reiterated the points made by ADM Gideon when she addressed the Atlantic All Chiefs Forum on the Budget 2012 federal funding reductions. APC prepared a briefing note for the MMAHB participants on the ADM’s presentation and inserted it in the MMAHB meeting package. Debra also spoke briefly about the Branch’s development of a new regions/headquarters accountability structure in light of the new headquarters organizational structure and the new FNIHB national Strategic Plan that is expected to be distributed early this fall. Changes to the region’s organizational structure are also expected to be known in the months ahead.

Debra used the rest of her allotted time to field questions:

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Q. Why did some PTOs get bigger cuts than others? A. Debra stated that direct service delivery portion of the PTO funding was protected. After the reductions, each of the provincially based First Nations organizations in Atlantic Canada will have similar levels of health funding for the area of consultation/liaison.

Q. Why were cuts done in the first year instead of year three? A. These decisions were made in Ottawa.

Q. Should we expect more cuts over the next couple of years? Communities are already struggling because the funding formula does not rise with population increases. A. We do not expect further cuts in the next couple of years. Health Canada has tried to address the need to reduce funding in the first year, and we are not looking to stabilize. Communities will continue to receive a 3% annual increase in their Indian Envelope funding.

Q. Who decided to make the official cuts, was it HQ or FNIHB Atlantic? A. The overall funding reduction targets as well as the overall areas to be protected or reduced were set in Ottawa. Within these parameters, Ottawa sought and approved proposals from the regions to meet the funding reduction targets.

Q. Why were some regions affected less than others? A. BC was not reduced because they are in the midst of a tripartite agreement development. Tripartite agreements are encouraged by the federal government.

6.) 2011-2012 Financial Information (Frank Fleet):

Frank used a Powerpoint Presentation of which a hard copy was included in the MMAHB meeting package. Frank was responding to action items #8 and #9 of the March 2012 MMAHB meeting which asked for financial information related to the activities in the strategic action plans (mental health, addictions and elder care).

Chief Candice Paul asked about the “NNADAP staff certification” item ($200,800). The Chief wants to know when her NNADAP prevention staff receive certification incentives. The Chief asked a variety of questions on this topic. Debra noted that this topic had been raised at a previous MMAHB meeting and FNIHB had a prepared a briefing note to MMAHB.

Action Item #6: Dr. Poulin will provide MMAHB an update to the Sep 16, 2011 briefing note on the topic of NNADAP staff certification incentives.

7.) 2011-2012 Financial and Utilization Information on NIHB

In the interest of time, this item deferred to next meeting.

8.) Implications of the Financial Transparency Act

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In the interest of time, this item deferred to next meeting.

9.) Proposed Terms of Reference – MMAHB & NIHB Committee:

Chief Darlene Bernard, member of the MMAHB Evaluation Committee, delivered a Powerpoint presentation that outlined proposed terms of reference for MMAHB and a new MMAHB committee focused on Non-Insured Health Benefits. See the MMAHB meeting package for a hard copy of the presentation. Chief Bernard stated that the Committee is looking for feedback from MMAHB, and that finalization of the Terms of Reference would be sought at the September MMAHB meeting before seeking approval by the Atlantic All Chiefs Forum.

Action Item #7: Amanda Peters will clarify whether there is support for an Innu Nation member of MMAHB.

Decision: The MMAHB Chiefs/Proxies unanimously agreed that under the Scope of Decision Making section of the MMAHB Terms of Reference decisions of $50K to $250K should move the not be decided at the MMAHB committee level, but decided at MMAHB level itself upon receiving a recommendation from the appropriate MMAHB committee. The FNIHB MMAHB members abstained from voting on the decision.

10.) Federal Tobacco Control Strategy (FTCS) First Nations and Inuit Stream

With the consent of MMAHB, a late item was added to the agenda by FNIHB. Brenda Roos explained that four days ago, FNIHB was made aware that contribution funding through the renewed FTCS (FN&I Stream) will be made available to the region to support an estimated five projects. These projects would be expected to develop and implement comprehensive, integrated and sustainable tobacco control strategies into community based programming, services, and policies. Projects would be expected to be aligned with the evidence based approach outlined in the World Health Organization’s Framework Convention on Tobacco Control. A comprehensive strategy includes a full range of interventions: prevention, cessation, education, protection, pricing, surveillance, and evaluation. A total estimated $500K may be available to the region for such projects each year for 5 years. Timelines are very short, projects to be identified in July for the projects to be rolling in August.

11.) Next Meeting: There will be a 2 day MMAHB meeting on September 19 and 20 in Dartmouth.

12.) Closing Prayer: Elder Christine Boone

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MMAHB AGENDA October 18th, 2012 (9:30am-4:00pm) and October 19th (9am-noon) APC Head Office, Dartmouth

Coffee and Networking 9:30 Opening Prayer (Elder) Introductions, Approval of Agenda & Minutes (Chairperson) 10:00 Acknowledgement of Standing Written Reports (Chairperson) 10:25 The following standing reports requested by MMAHB are: Heath Services Integration Fund, Aboriginal Health Human Resources Initiative, Contribution Agreement Funding, Health Information Management (ie. Panorama, Tele-health, Surveillance Capacity Project). Regional Roundtable (MMAHB Chiefs, response from FNIHB RD) 10:30 MMAHB Committees Reports (Committee Co-Chairs) 11:15 Each MMAHB committee (co-chairs) provide a 5 min verbal report of key issues, accomplishments or direction sought. 5 min for questions. Implications of Bill C-27, First Nations Financial Transparency Act (Kandace Terris) 11:50 Kandace Terris will share what she knows about possible implications of the proposed legislation on health funding and First Nations reporting. LUNCH 12:00 Plan MMAHB Health Information Session (Agatha Hopkins) 1:00 Discuss agenda, date, and invitee list to confirm scope of session on health information. 2011-2012 NIHB Usage Information (Louise Cholock) 1:30 In response to MMAHB requests, FNIHB will present year end actuals on utilization and cost by benefit category. This will be shown for the region as well as the McIvor clients and Qalipu clients. Child and Youth Strategy (Sally Johnson & James McGrath) 2:00 Child and Youth Co-chairs will present the final Atlantic First Nations Child and Youth Strategic Action Plan. Child and Youth Committee will seek endorsement for the plan. Update and Next Steps for Implementing Recent MMAHB Decisions 3:00 Drug Utilization and Prevention Projects Funding (Christiane Poulin) Federal Tobacco Control Strategy Projects Funding (Sandra Musgrave) MMAHB Terms of Reference and MMAHB Committees Terms of Reference (Amanda Peters and Wade Were) Setting of Next Meeting Date and Closing of Day 1 4:00

Day 2 Coffee and Networking 9:00 Dialogue with Atlantic Treatment Centres (Treatment Centre Directors) 9:15 The Directors of the Atlantic First Nations treatment centres will present on their treatment philosophy, programming and modernization activities/plans. A facilitated discussion will follow on the topic of identifying and addressing unmet addictions treatment needs within the greater provincially/federally funded health system. Closing Prayer 12:00

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MMAHB Meeting October 18, 2012 APC Head Office, Dartmouth, Nova Scotia

MMAHB Members Present Attendees: Representing: Attendees: Representing: Voting members: Chief Candice Paul APC NB Co-Chair Debra Keays-White FNIHB Chief Deborah Robinson APC NS Co-Chair Leila Gillis FNIHB Chief Brian Francis MCPEI Louise Cholock FNIHB Chief Andrea Paul/L. Francis CMM Agatha Hopkins FNIHB Chief Aaron Sock MAWIW Tryna Booth FNIHB Chief Leroy Denny UNSI Sandra Musgrave FNIHB Chief George Ginnish UNBI Non-voting members: Elder John Joe Sark APC Elder James McGrath C&Y Co-Chair Christine Gabriel APC Elder Sally Johnson C&Y Co-Chair Proxy Claudia Simon PHC/PH Co-Chair Janet Pothier Wellness Co-Chair Susan Ross PHC/PH Co-Chair Morley Googoo AFN Vice-Chair

MMAHB Members Absent Vice Chief Roger Augustine AFN Vice-Chair Kandice Terris FNIHB Chief Mi’sel Joe Miawpukek NFLD Charmane Kay Wellness Co-Chair

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Grand Chief Ben Sylliboy Mi’kmaq Nation Christiane Poulin FNIHB

Guests/Observers Present Amanda Peters APC Wade Were FNIHB Chelsea Googoo APC Roseanne Sark MCPEI John Paul APC Mindy Denny UNSI Gerald Gloade UNSI Gillian Bailey FNIHB Janna MacKay UNSI Dougall MacDonald AANDC Joe Denny NADACA Lloyd Gould NADACA Rose Purdy NADACA Leanna MacLeod NADACA

Agenda Items Notes Actions 1. Opening Prayer Grand Chief Sylliboy 2. Introductions,  Co-chairs Chief Candice Paul & Leila Gillis. Agenda Item #5 deferred until approval of agenda &  Agenda Item #5 is deferred. No additions. Acceptance moved next meeting. minutes by Chief George Ginnish and seconded by Sandra (Item #5 is “Implications of Bill C- Musgrave. 27, First Nations Financial  Review of minutes: Acceptance moved by Leila Gillis and Transparency Act”.) seconded by Chief George Ginnish.  Status of Action Items from June 19th minutes: Related to (June) Action Item #3, o Action Item #1: completed. FNIHB agreed to report at the o Action Item #2: completed. Mental Wellness Committee on o Action Item #3: completed. how its various programs are o Action Item #4: completed. intended to contribute to Mental o Action Item #5: completed. Wellness. o Action Item #6: completed. o Action Item #7: completed. 3. Acknowledgement Chief Candice Paul acknowledged that the MMAHB requested standing of Standing Reports reports are in the meeting packages. 4. Regional Chief Candice Paul (APC Co-Chair) Action Item #1: APC to draft a Roundtable  Chief Candice referenced one of the six strategic directions (#5) letter to the federal Minister of from the Mental Health Strategy for Canada that calls for access Health communicating the to a full continuum of culturally safe mental health services for perspective of the MMAHB Chiefs

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Agenda Items Notes Actions First Nations. The Chief asked about the status of this on advancing strategic direction recommendation, and noted the importance of having such a #5 of the Mental Health Strategy continuum developed with First Nations. Leila stated that for Canada. FNIHB is in the early stages of planning a Canada-wide engagement process to develop a First Nations mental wellness continuum framework, and added that she expects that the MMAHB Mental Wellness Committee will be involved.  Concerned with NIHB’s orthodontics and direct billing and wants clarification on the process. NIHB’s Regional Dental Officer to follow up with Chief Candice.

Chief George Ginnish (UNBI)  Chief George wants to ensure that the Atlantic Child and Youth Strategic Action Plan is not lost in the new larger Public Health and Primary Care Committee of the MMAHB. Leila confirmed that the Action Plan needs to be implemented by FNIHB, APC, and Atlantic First Nations. The new Public Health and Primary Care Committee will track progress.  Chief George reflected on the importance of the federal government holding NIHB-defrauding pharmacies accountable. Leila explained that there is a rigorous audit process at NIHB that flags issues and there is a process for recovery when fraud occurs.  Chief George noted that UNBI has been seriously impacted by the recent federal funding cuts impacting the viability of the entire organization. Leila stated that FNIHB is willing to work with UNBI on ensuring continuity of services in light of the budget cuts. Action Item #2: FNIHB to provide Chief Brian Francis (MCPEI) a written report on the role and  Chief Brian asked what is the role of FNIHB’s Physical Activity activities of the Physical Activity Specialist given it has no funding for these programs. Leila Specialist. Included in the report stated that the Specialist has a small ADI-based budget and should be success stories where funds modest proposals from communities. The Specialist also communities have accessed non- helps communities develop ideas/proposals around physical FNIHB sources of support. fitness and promotes access to non-FNIHB sources of funding.

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Agenda Items Notes Actions

No response from CMM, UNSI or MAWIW Council 5. MMAHB Committee Child and Youth Committee (Co-chair James McGrath) Reports  A written report was provided. James gave a verbal update on the work of the committee which focused heavily on the development of a Child and Youth Strategic Action Plan.

Wellness Committee (Co-Chair Janet Pothier)  A written report was provided. Janet gave a verbal update on the work of the committee which focused largely on preparing for the MMAHB-NNADAP treatment joint meeting, and the allocation of DUPP (drug utilization, prevention, and promotion) projects funding.  Janet noted that FNIHB Atlantic’s mental health section has many position vacancies which is concerning. Leila indicated that FNIHB was in the process of staffing.  Also more broadly, Leila noted that FNIHB Atlantic will be looking to engage MMAHB on its transition plan in the coming months. The plan is meant to guide the FNIHB Atlantic’s organizational design to best support the implementation of the national strategic plan and the new accountability framework. John Paul noted the importance of FNIHB organizational design to the work of the communities.

PHC&PH Committee (Co-Chair Susan Ross)  A written report was provided. Susan gave a verbal update on Action Item #3: FNIHB will the work of the committee which focused on the sharing of provide APC a fact sheet on the success stories from committee members. national FNIHCC evaluation. The  Chief Candice Paul inquired about a letter she received asking fact sheet can be distributed to her to participate in a national evaluation of the FNIHCC MMAHB Chiefs and the PHC&PH program. The Chief expressed concern that this letter was not committee members. supported by sufficient background information (framework, etc.) nor was it communicated through the PHC&PC Committee. Dougal asked if the survey would differentiate between Health Canada and AANDC home care/support.

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Agenda Items Notes Actions

6. 2011-2012 NIHB Louise Cholock delivered a Powerpoint presentation of which copies Action Item #4: FNIHB will Usage Information were included in the meeting packages. repeat this NIHB financial and (moved to 11:30am)  Louise stated that region receives additional funding for the utilization presentation in a year Qalipu’s NIHB costs. The final budget is expected to be known (including Qalipu and McIvor in April 2013. The Qalipu enrollment process continues until analyses). November 2012, and the number of Qalipu is expected to far exceed original estimates. Concern was raised that Qalipu and McIvor will eventually negatively impact pre-existing regional clients of NIHB.  AANDC was asked whether it will seek additional funding to Action Item#5: MMAHB asked support communities to service a higher Registered Indian the NIHB Committee to look at population resulting from the McIvor decision. AANDC how the utilization of the continues to review the numbers to assess the materiality of the STCIMHC benefit can be McIvor decision. increased through such activities  A concern was expressed that the Short Term Crisis as promotion and removal of Intervention Mental Health Counselling continues to be barriers. underutilized.

7. Atlantic First Child and Youth Committee Co-chairs James McGrath & Sally Johnson Nations Child and delivered a Powerpoint presentation on the recommended Atlantic First Youth Strategic Plan Nations Child and Youth Strategic Action Plan  The Co-chairs stressed how the implementation of the Plan depends on community level partnerships. Communities are encouraged to use their interagency committees and be inclusive of social sector and others.  AANDC asked to have the Strategic Action Plan presented to Child and Family Services Agencies across the region.  The Committee was commended for its development process and final product. It was encouraged to seek opportunities to present at national tables. Decision: MMAHB endorsed the Atlantic First Nations Child and Youth Strategic Action Plan as presented. Motioned by Chief George Ginnish and seconded by Louise Cholock. Unanimously passed.

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Agenda Items Notes Actions

8. Update & Next  Agatha presented an approach to planning and holding a Steps for MMAHB Health Information Management Session in January Implementing 2013, and sought MMAHB’s support to proceed. MMAHB Decisions Decision: MMAHB will participate in a Health Information Management session in 2013. Motioned by Chief George Ginnish and seconded by Chief Brian Francis. Unanimously passed.  Leila provided an update on the DUPP funding: Funds will roll out to the successful proponents of the RFP Process in January 2013.  Leila provided an update on the Federal Tobacco Control Strategy funding. MMAHB has previously decided on how it would like to see the funding administered in the region. FNIHB is discussing roll out at a national level.  Amanda spoke about the next steps in implementing the recently approved terms of reference for MMAHB and its committees.

9. Setting of Next MMAHB will next meet on January 15 and 16, 2012 at the Membertou Action Item #6: APC will send Meeting Date & Trade and Convention Centre. out a calendar invite for MMAHB’s Closing of Day 1 next set of meeting dates.

Note: Day 2 Special Meeting on Addictions Notes are found in the Report from Janet Rhymes, Consultant. See attached

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Meeting Information

DATE: January 15, 2013

LOCATION: Membertou Trade and Convention Centre, Membertou Nova Scotia

Agenda Items Time Item Presenter 9:00-9:15 Opening and Introductions 9:15-9:45 General Items Co-Chairs  Acceptance of Agenda  Review of Minutes and Action Items  Acknowledgement of Written Reports 9:45- MMAHB Orientation Amanda Peters (APC) 10:45  Role of MMAHB  Scope of Decision Making  Responsibilities of Members  Meeting Processes (motions etc)  Meeting schedules  MMAHB Cycle  Chiefs Health Priorities and Strategic Action Plans  Role of the Committees  Questions 10:45- Committee Co-chairs Report Committee Co-chairs 11:15  NIHB Committee Report  Public Health and Primary Care Report  Mental Wellness Report 11:15- Regional Roundtable Regional MMAHB Chiefs 12:00 and Debra Keays-White (FNIHB) 12:00- Lunch 12:30 12:30- 2013-14 Funding Decisions FNIHB Committee Co- 1:30 Chairs 1:30-3:30 FNIHB Transition Plan Debra Keays-White (FNIHB) 3:30 – Report on Addictions Meetings Janet Rhymes, Consultant 5:00  Review of the reports from the Oct 19 and Nov Mindy Denny, RHS 20 Coordinator  Regional Health Survey Data Mental Wellness  Direction to the Mental Wellness Committee on next steps Committee Co-Chairs 5:00-5:15 AAEDIRP Research Project – Addictions and Margaret Donahue, APC Economic Development in Atlantic Aboriginal AAEDIRP Communities. Amanda Peters, APC Health 5:00-5:15 Resolutions for All Chiefs Amanda Peters, APC

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5:15-5:30 Closing

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MMAHB Meeting January 15, 2013 Membertou Trade & Convention Center

Voting Members Present Absent Chief Brian Francis MCPEI Chief Candace Paul UNBI Chief Andrea Paul CMM Chief Aaron Sock MAWIW Chief Norman Bernard UNSI – 11am Chief Mi’sel Joe NL FNs Debra Keays-White FNIHB

Non-Voting Members Present Absent Chief Deborah Robinson APC Co-Chair (NS) Vice Chief Roger AFN Vice Chief-NB Augustine Vice Chief Morley AFN Vice Chief (NS) – Elder Margaret Jadis PEI Elder Googoo 1pm Janet Pothier MWC Co-Chair (FN) Elder Christine Boone NB Elder Gillian Bailey MWC Co-Chair (FNIHB) Sally Johnson NIHBC Co-Chair (FN) Roseanne Sark PHPC Co-Chair (FN) Leila Gillis PHPCC Co-Chair (FNIHB)

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Louise Cholock NIHBC Co-Chair (FNIHB) Dougal MacDougall AANDC

Guests in Attendance John Paul APC Kelly Bonnell AANDC Amanda Peters APC Tryna Booth FNIHB Chelsea Googoo APC Wade Were FNIHB Laurie Nicholas MAWIW Janet Rhymes APC’s Consultant Gerald Gloade UNSI – RHS Analyst

Agenda Items Notes Actions 1. Opening and - The meeting was scheduled to start at 9:15am. At 9:45am, Introductions in the absence of a quorum, the voting members present decided to begin the meeting by discussing items that did not require a vote. With the agreement of the Chiefs, Debra Keays-White chaired the morning portion of the meeting, and presented on the Transition Plan (item #7). When a quorum was achieved at 11am, Debra confirmed the action item regarding the Transition Plan for the record. Debra also acknowledged the special effort made by Chief Norman, who had only been informed of the meeting on the day of the meeting due to an incorrect email address. - The FN representatives elected Chief Brian Francis to chair the afternoon portion of the session. FN voting members agreed to select a Co-Chair for future meetings after this meeting.

2. General Items: - The agenda was accepted as distributed. The order of the Action Item #1: At the May - Acceptance of items was managed by the Chairs. MMAHB meeting, Frank Fleet will

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Agenda Items Notes Actions Agenda - The minutes of the October 2012 meeting were accepted as report on how the FNs Financial - Review of Minutes distributed. Transparency Act will impact action items - MMAHB reviewed the action items from the October health funding agreements. - Acknowledgement meeting: of Written Reports o Transparency Act Implications will be covered at the next meeting of MMAHB by Frank Fleet. o FNIHB agreed to report on how its programs are intended to contribute to mental wellness, and this will be done as part of the strategic action planning work of the Mental Wellness Committee. o #1: APC is in the process of drafting a letter to the federal Minister of Health communicating the perspective of the MMAHB Chiefs on advancing strategic direction #5 of the Mental Health Strategy of Canada o #2: Completed; the report is attached in the MMAHB packages. o #3: Completed; the evaluation has been sent to the MMAHB Chiefs. o #4: Presented during the October 2012 meeting and will be done again at fall MMAHB meeting o #5: The NIHB Committee has been tasked to determine how to increase the utilization of the STCIMHC benefit o #6: Completed - Debra acknowledged the standing reports requested by MMAHB located in the meeting packages.

3. MMAHB - Amanda Peters and Wade Were presented the MMAHB Action Item #2: APC Staff will Orientation Orientation. In detail the presentation included: the role of prepare MMAHB Orientation MMAHB; the scope of decision making for MMAHB, the binders for the MMAHB members. committees and FNIHB; the responsibility of all the members;

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Agenda Items Notes Actions the meeting process and scheduling; the MMAHB Cycle; the work being done for the 4 priorities of the Chiefs’ and the strategic action plans; and the role of the MMAHB committees. A few questions and comments were made around attendees to MMAHB meetings and communications to the Chiefs. Amanda indicated that APC would be leading the development of a communications plan for MMAHB.

4. Committee Co- - Each committee introduced their Co-Chairs, provided the Action Item #3: At the May chairs Report: MMAHB a written report, and spoke briefly on highlights in MMAHB meeting, the Mental - NIHB their reports. The priority for each Committee was the Wellness Co-Chairs will - PH and PC development of a 2013-14 work plan. present a project plan and - Mental Wellness - The NIHB Committee noted that they would be leading work timeline for the engagement on the short term crisis intervention mental health counselling and development of a MH&A benefit. Strategic Action Plan - The Primary Care and Public Health Committee advised that the FNIHB Co-chair would change with the departure of Leila Gillis. The committee also highlighted its work in championing the Strategic Action Plan on Child and Youth Health. - The Mental Wellness Committee provided an update on the DUPP funded projects, and explained that it will meet with RAPC later in the week to establish linkages. The Committee recommended the development of a single Mental Health and Addictions Strategic Action Plan that built on previous work and linked to the national Mental Health Continuum engagement process.

Decision: MMAHB unanimously directed the Committee to return to the next MMAHB meeting with a plan and timeline for the engagement and development of a MH&A Strategic Action Plan.

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Agenda Items Notes Actions

5. Regional - Debra introduced the Roundtable session by emphasizing Action Item #4: Louise will Roundtable that this was an opportunity for each voting member to provide APC and update on acknowledge achievements or milestones as well as the FNIHB’s negotiations with issues. PHANS for distribution to - Chief Andrea Paul: MMAHB Chiefs. (1) Gave a brief update from the recent AFN CCOH (Chiefs Committee on Health) meeting that took place in November. The CCOH will do a newsletter with fact sheets. The next quarterly CCOH meeting is Feb 4-5. (2) Asked about the status of the PANS (Pharmacy Association of Nova Scotia) negotiations with FNIHB. Louise stated negotiations are at a stalemate since May 2012, but status quo services continue and are anticipated to do so. (3) Asked whether the region was going to support an Elders Gathering. Debra noted that she understands that the Chiefs are supportive of a Gathering. FNIHB is willing to partner with others, and would consider a funding proposal. The Elder Care Working Group is trying to determine a focus and would like to hear from Chiefs. Chief Norman indicated his communities focus is reconnecting elders and youth.

- Chief Brian Francis: (1) Asked what MMAHB Committee is the lead monitoring the implementation of the Elder Care Strategic Action Plan indicating that the NIHB Committee would be preferred. Debra agreed that a Committee needed to be designated as the lead, and that FNIHB would need to discuss. (2) Want FNIHB to include First Nations input in the hiring

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Agenda Items Notes Actions of the new Mental Wellness Lead. Debra said the job description is in classification. She noted that she would like FN involvement in the development of a Statement of Merit and interview questions, and will seek a FN representative. (3)Asked for the status of the FN’s component of the Federal Tobacco Strategy. Debra stated that decisions on Tobacco Strategy next steps are being made in Ottawa. (4) Asked for the status of FNIHB’s development of a Framework for a Mental Wellness Continuum. Debra stated that regional engagement will happen in the new year with the oversight of an interim FNIHB Mental Wellness lead and the involvement of the Mental Wellness Committee. - Chief Norman Bernard: - Expressed concerns about the aftercare of people with addictions. He feels more financial assistance to aftercare programs is needed to avoid relapses. Debra stated that she looked forward to discussing such matters under the addictions item later in the agenda. - John Paul: The voting members asked John Paul to provide an update on the Ottawa meeting with PM Harper and the Chiefs. He spoke of how the Prime Minister responded to the 8 major points raised by the AFN: 1.) The PM agreed to work with FN Chiefs on issues with treaties and to establish a new cabinet committee. 2.) On land claims: The PM agreed with fair facilitation on the comprehensive claims policy rather than extinguishment. 3.) On resources: develop a framework of shared governance for revenue sharing; FN to work more closely with the provinces.

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Agenda Items Notes Actions 4.) Legislation on Bill C-38 and Bill C-45: to respect and to rebuild nation building; the PM is aware of the flawed Indian Act: wants to work with FN and provide more flexibility, open for suggestions on an effective Indian Act. 5.) Transforming the fiscal/funding relationship: The PM’s statement: First Nations’ receive annual funding increases. 6.) National inquiry on Violence against FN Women: The PM agrees with the Chiefs that violence against all women should end is open for suggestions. 7.) Shannon’s Dream: The PM agrees about the importance of education and for national consultation; discussion needed for post-secondary education at some point. 8.) Effective progress of the machinery of the government: establish a committee immediately on all national Aboriginal issues: The PM agreed and conceded a need for political and central oversight at Privy Council office to achieve objectives. - Debra Keays-White: (1) Debra indicated to Chiefs that contribution funding would be released to bands earlier in 2013-14. (2) FNIHB is focused on working with bands to get outstanding reports so that funding does not need to be held back. (3) Debra noted that with very tight controls on travel, FNIHB needs to plan to attend large meetings like MMAHB well in advance so that approvals from Ottawa can be obtained. Adherence to the planned MMAHB meeting dates is essential. (4) Leila Gillis was thanked for her years of service. John Paul echoed the recognition of Leila’s contributions.

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Agenda Items Notes Actions 6. 2013-14 Funding - Amanda and Wade made a Powerpoint presentation on Decisions the 2013-2014 contribution funding decisions and made recommendations on behalf of the MMAHB committees. The presentation was included in the meeting package.

Decision: MMAHB unanimously accepted all the committees’ recommendations listed in the Powerpoint presentation.

7. FNIHB Transition Debra delivered a Powerpoint presentation on the newly Action Item #5: The MMAHB Plan proposed FNIHB Transition Plan (copies distributed). Debra Chiefs agreed to provide their asked for feedback from the MMAHB on the new transition plan. questions and comments on She explained that while the national Strategic Plan and the Transition Plan to Debra by Accountability Framework are final, the community focus teams January 31, 2013 and agreed concept is flexible and the organizational structure can be to turn around a response in modified but national standardization on language and three weeks. groupings remains important. The discussion covered such topics as tripartite relations, regional advisory structures, alignment of national and regional organizational structures, roles of Community Development and Liaison Officers and the AANDC model of community focused teams, evaluating as we implement the transition plan, transfer and long term role of FNIHB, impact of the recognition of Non-Status Aboriginals/Metis, impact of the Qalipu creation on NIHB, FNIHB’s loss of contribution agreement expertise, and 2013-14 cash flow schedules.

8. Report on Gerald Gloade from UNSI presented on addictions and mental Action Item #6: Amanda will Addictions Meetings wellness data from the Regional Health Survey (RHS). Janet investigate how to obtain an to the MMAHB Rhymes reviewed her 2 written reports from the last 2 special Atlantic RHS report with narrative. MMAHB sessions on addictions.

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Agenda Items Notes Actions Decision: The MMAHB instructed the Mental Wellness Committee to use the RHS Phase 2 data and the reports form the two MMAHB special sessions on addictions to inform the development of a Mental Health and Addictions strategic action plan.

Decision: The MMAHB unanimously requested a report on Atlantic region RHS data complete with narrative. Motion: Chief Andrea; Second: Chief Brian.

9. AAEDIRP Amanda spoke of an APC project investigating the economic Research Project – impacts of illicit and prescription drug abuse in Atlantic First Addictions and Nations communities. She asked the MMAHB if it would support Economic the project’s researchers accessing NIHB data from FNIHB. Development in The data would not identify individuals or communities, but Atlantic Aboriginal rather be aggregated to the Atlantic regional level. Amanda Communities noted that the research had to pass the Mikmaq Ethics Watch and Dalhousie University ethics processes.

Decision: The MMAHB unanimously agreed to allow the researchers access to NIHB aggregated data for the above stated purpose.

10. Closing Chief Brian stated that the next MMAHB meeting is a special Action #7: Amanda will send session on Health Information Management on March 5-6 in an email to the MMAHB FN Halifax. This is followed by a regular MMAHB meeting on May voting members about 14-15 in Moncton. nominations for a FN co-chair of MMAHB. Chief Brian stated that the selection of a FN MMAHB Co-Chair will be done through email and phone calls between the regular meetings to ensure that all FN voting members participate in the decision.

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Summary Report: Addictions in Atlantic First Nations Communities: Strengths, Gaps and Opportunities for Action

By: Janet Rhymes

Overview

This is a summary of two meetings of First Nations Treatment Centre and Native Alcohol and Drug Abuse Counselling Association of Nova Scotia (NADACA) program staff, Atlantic First Nations Chiefs, health staff and First Nations and Inuit Health Atlantic Region (FNIHB) staff on the topic of drug and alcohol addiction in First Nations communities.

Meeting 1 was held Friday, October 19 in Cole Harbour Nova Scotia. This meeting included presentations from treatment centre staff to enhance understanding of NADACA programs, services and philosophies. Regional Health Survey data on addictions and mental health were shared. Participants collectively identified the strengths available in combating addiction, the severity of the issue, and challenges and gaps in addressing it. Some potential action steps for moving forward were shared.

Due to time limitations and the scope of the topic, a second meeting to identify and agree upon actions was requested by the MMAHB Chiefs. This meeting was held on Tuesday, November 20, 2012 (evening) during the November Atlantic First Nations Health Conference in Moncton, New Brunswick. This meeting was a continuation of the discussion and sharing held October 19th. In addition, comments from the attending public were welcomed if it further informed or enhanced the content shared.

This report summarizes the discussions held at these two meetings and provides starting points for further action. The meeting information is provided in three sections:

1. Overview of Regional Health Survey data 2. Atlantic Treatment Centre contacts and links 3. Participant observations and suggested actions. This includes general observations and actions, as well as observations and actions within four areas: prevention, enforcement, supports/services and harm reduction.

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1. Regional Health Survey Presentation Summary

Drugs and alcohol:

Youth (12-17) - Increase in male binge drinking - Youth not seeking help (the numbers for those who sought help are too small to report) - Youth see alcohol and drug addiction as "the biggest challenge facing their community" and do not feel they are seeing any change in this

Adults (18+) - Stats available on binge drinking weekly and month--both rates are of concern - Highest use levels for cannabis, sedatives and opioids - High rates of problem gambling; majority not seeking treatment

Mental health:

Youth - Low percentage of youth identifying as in poor mental health; very few youth with - poor mental health seek counselling - Suicide still of concern and many affected by loss from suicide - Female youth rates of suicide contemplation higher than for young men (suicide - ideation) - Depression is an issue for youth. Depression has increased among both male and - female youth and is higher for females than males. - Bullying is also an issue. More female youth report issues with bullying than make - youth.

Adults - Adults, too, are significantly affected by losses from suicide. Adults results are similar - to youth results. - According to national data, the rate of adults affected by suicide in Mi'kmaq - communities (NS) is more than double that of all First nations communities across - Canada - Many adults have experienced racism - Note: The RHS respects the OCAP principles. A formal request for the detailed data has - been made by MMAHB leadership, owners of the data. Published data is not yet available to - the public but will be available in the near future.

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2. Atlantic Treatment Centre Presentations

- Joe Denny, Executive Director, Native Alcohol and Drug Abuse Counselling Association of Nova Scotia (NADACA), www.nadaca.ca - Lloyd Gould, Clinical Director, Mi'kmaw Lodge Treatment Centre, Eskasoni First Nation, www.nadaca.ca/mikmaw-lodge.html - Leanna MacLeod, Clinical Director, Eagle's Nest Treatment Centre, Indian Brook, http://nadaca.ca/eagles-nest.html - Rose Purdy, Community Addictions Counsellor, Acadia First Nation - Chief George Ginnish, on behalf of Cindy Ginnish, Executive Director, Rising Sun Treatment Centre, Eel Ground First Nation, www.risingsuntreatment.ca

Joe Denny shared the history of NADACA, which began as a UNSI pilot in 1971 and which recently celebrating their 40th anniversary in 2011. In that time, they have expanded programs and services in the midst of an ever-changing addictions and societal context- -new problems, individuals with multiple addictions and/or addictions beyond alcohol, and a rise in youth substance abuse. To meet these needs, their services have expanded, modernized, and have become more professional. There are NADACA counsellors on every reserve, they support two treatment facilities and their staff work along the addictions spectrum-- prevention and education, treatment, support and long-term recovery.

The additional presentations provided an overview of services and approaches, including new programs designed to address new and emerging concerns. The presentations shared by speakers are available electronically by contacting APC Health staff.

3. Observations and Action Opportunities Identified

Notes:

• Participant observations and potential actions shared are not necessarily true for all communities. All communities are different. The large group meeting format and lack of time meant that not all participant perspectives were heard on all topics. • For ease of reading, input shared by meeting participants was summarized and clustered.

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Addiction and drug abuse is at crisis point in many communities. There are individual, family and community impacts.

- This is a “family disease”. It affects individuals, family and friends. Users are in pain and self-medicating. Grandparents are taking on a greater role as caregivers due to addiction. Children are being taken from homes. They suffer further when taken into off-reserve foster care. Detachment has a huge impact. - It is challenging to find a balance between supporting individuals in crisis and at the same time ensuring the safety of families and the community. And given the current and historical trauma and losses people and communities have suffered, there is reluctance to ask individuals to leave/not have them supported in community. - This is a whole community issue. Chief and Council have a responsibility to get rid of drug and alcohol problems, as do other agencies and providers such as the RCMP. - Crime is on the rise in communities as a result of addiction. Elder abuse is also happening. People are taking advantage of/are abusing elders for money.

Addiction is a complex and growing issue and a symptom of deeper problems.

- Addictions are the 'tip of the iceberg'--the visible part of the less visible impacts of colonization and IRS trauma, poverty, racism, marginalization, inadequate housing and so on. The root of the problem is enforced dependency from the government: high unemployment and high welfare rates. We now need to take care of ourselves. All treatment centres won’t solve the problem. There are deep-rooted issues that got us here. We need nation-building. - To heal, we need to get to the root of the problem. All forms of abuse need to come out, be heard and dealt with. Parents are sick and kids are in pain and thus abusing drugs and alcohol. - The needs and scope of addiction is greater and more complex than ever before. This includes, for example, rising rates of prescription drug abuse and use of bath salts in some communities.

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- A new piece of legislation may mean that some prescription drugs will be cheaper. - Although needs are great, growing and evolving, the ability of NADACA to provide additional services is limited by lack of funding and resources. There is no core funding for the cultural component of NADACA programs. Prevention is the most under-funded part of NADACA programs. More investment is needed for youth prevention. There are low salaries, few tools, and a low budget. - There are assets and strengths that provide opportunities for action - The Seven Sacred Teachings are an asset for treatment and for people along their healing journey. They are also being used in some communities in a variety of ways and settings so they offers a chance for consistent education and messaging for prevention. Keep culture (including the Seven Sacred Teachings) and language at the foundation of addiction and healing services. - Successful approaches used by NNADAP and NADACA are strengths with learnings to be shared. NADACA services are culture-based and include the Seven Sacred Teachings. There are service links between the field workers and the treatment centres. NADACA staff are knowledgeable and experienced. NADACA offers a range of programs--treatment programs, day programs, community programs and prevention/education. These provide support across the addictions spectrum and are modernizing and evolving. Life coaching is included as part of NADACA treatment programs. - There are many individual success stories from recovering addicts and role models that can be used as examples of recovery for prevention and education. - Community members, including youth and those who have experienced addictions, need to be involved in finding solutions. Getting to the root of the problem means Healing Lodges and healing opportunities are needed in each community. - Host community meetings with all partners involved, including health and justice. - We need to support a state of positivity instead of negativity. The Grand Chief spoke about creating a new normal and a new language. For example 'life promotion' instead of 'suicide.' Talk about hope, vision, goals and build on that instead of focusing on the negative. Be inspiring. - The system does not allow Aboriginal peoples to do what works. We need to put culture back into the system. Our strengths are community, cultural beliefs, language and people. - Keep looking at the big picture, not just the problem and focus on what is working. - Part of focusing on the big picture and getting to the root of the problem is also taking a wholistic, multi-disciplinary approach: employment, nation-building, empowerment, education and so on. This is true for individuals but community transformation is also required. We need to support each other. - A website for sharing information, tools and approaches is needed. - FNIHB sits on a national forum and can bring best practices back to the MMAHB. - The Chiefs need to advocate for more funding for NADACA.

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- Write a letter from the co-chairs to Leona Aglukkaq on the scope of drug and alcohol addiction in the region and the need for Aboriginal specific detox and clinical therapists in each of the treatment centres (completed). - Increase funding for addiction through federal and/or provincial partnerships. - A strategy for action on improved Mental Health and Addiction is needed. This must be developed collaboratively, in the same way that the Child and Youth strategy has been developed.

1. Prevention

Prevention observations

- More of a focus is needed for prevention and yet it is an underfunded area. This is the most underfunded part of NADACA programs. - Suggested that NADACA and NNADAP work together on prevention, including innovation and technology and integration. - Youth have the answers but must be invited in to meetings to share and learn what they might want and have to offer. Those most affected must be part of developing the plan for change. - Young men, in particular, have lost their way and need to reclaim their role in our society. - Keep in mind that some youth are struggling with FASD. - There are few role models and incentives for youth in homes and in communities. There is a connection that is lost. - This is a symptom of a much deeper problem cause by things like dispossession and trauma. It will take years of rebuilding to regain pride and self-esteem. We need to listen to our kids and get to the root of the problems. Kids are abusing because they are bored and in a lot of pain.

Prevention opportunities

- More investment in youth prevention. - Use of Public Service Announcements (PSAs), technology and social media - Youth conference - Focus on youth smoking as non-traditional use of tobacco can be a gateway - Peer mentoring - Teach youth to deal with stress and anxiety by offering and engaging in more positive options and alternatives. Make this part of the school curriculum. - We need to support a state of positivity instead of negativity. The Grand Chief spoke about creating a new normal and a new language. For example 'life promotion' instead of 'suicide.' Talk about hope, vision, goals and build on that instead of focusing on the negative. Be inspiring. - Work with youth in the summertime, camps, sweat lodge, making baskets, drum and chanting...find ways to share the culture and bring back pride in culture. The answer is with sports, recreation, faith and spirituality. But this is not enough and there are not enough alternatives.

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- We need to change youth thought processes. - Consider the Aboriginal Shield program (community-led, RCMP-assisted http://www.rcmp-grc.gc.ca/aboriginal-autochtone/abo-aut-shield-bouclier- eng.htm) "enables Aboriginal youth to gain a sense of cultural connection and pride, while learning to make informed healthy lifestyle choices about drug use and related activities." - Parenting skills. - Share success stories from role models and recovering addicts. - The Seven Sacred Teachings are being used in a variety of ways in communities. it is good to have these common messages reaching community members from different sources.

2. Enforcement and Monitoring

Enforcement and Monitoring Observations

- No one should tolerate visible drug and alcohol use/abuse in communities. Partners from Justice and federal and provincial leaders also need to help with this issue. - Part of what has to change is the perception of drug dealers as role models. - Need to stop the selling of drugs on reserve. Some communities have had drug dealers removed from their community. Others are working to discourage the drug dealers by making it impossible to sell on reserve. This can lead to retribution. And again, given the current and historical trauma and losses people and communities have suffered, there is reluctance to ask individuals to leave/not have them supported in community. - We need a law to deal with drug dealers and discourage their business. We must take their house if necessary. But we need our own laws that we can support. - Need to balance intervention and zero-tolerance with the need for in-community and family-centred supports and services. - There is a need to address the over prescription by some doctors. Many people are taking pills and trading or selling them.

Enforcement and Monitoring Opportunities

- Investigate the use of drug courts - Need more individuals, peers, parents/guardians community leaders and non Aboriginal community partners (police/RCMP, mayor/wardens) to champion and stand against drug and alcohol abuse and drug dealing. - Spread the word within the community of the number to text/call when you see drug deal. - Need to protect the safety of those who take a stand against drug and alcohol misuse.

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- Discourage drug dealers by making it impossible to sell on reserve. Share policies from other reserves who have taken action on drug dealers. For example, look at the housing policies in Hobbema. - Communities and Chiefs should come together and do something about over-prescription. Identify 'pill doctors' using NIHB data. Support complaints through the College of Physicians and Surgeons with stories and other advocacy approaches.

3. Services and Supports, Including Treatment

Services and Supports Observations

- More research, services and supports are needed for prescription drug abuse. - Treatment programs are 35 days long, but need to be longer-term for some people. It is hard to keep youth in programs for more than 35 days and most clients are younger in age. - There is a lack of addiction supports and resources in communities once people leave Treatment Centres. - There are an increasing number of youth needing addiction and treatment services, but Treatment Centres cannot serve clients under 19. The only youth treatment centre is in Labrador. - There is no First Nations-specific detox. - There were clinical therapists in each treatment centre as part of the IRS funding, but this funding will end in 2013. There are no core-funded culturally safe mental health services in First Nations communities. - First Nations health workers are underpaid and overworked. - Some First Nations individuals are reluctant to use/discouraged from using off reserve treatment centres and off-reserve addiction and mental health services generally. - There can be stigma for those who go to AA. - Language and cultural teachings and practices, including the Seven Sacred Teachings, are core to the effectiveness of programs and services.

Services and Support Opportunities

- Safe houses are needed on reserves. - Healing Lodges in every community. - Self care opportunities and support groups are needed. - Opportunities for communities and families to honestly and in a supported way discuss abuse and begin the healing process. Create healing spaces where a range of services and supports are provided. People need connections and linkages to a range of supports and services - After-care supports are needed for people who have left treatment and return to their

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home communities. This could include a network of former addicts and a way to keep in touch with those who have gone through treatment. - Investigate the continued funding of clinical therapists in each treatment centre as part of the IRS funding. - Integrate sports, recreation, faith, spirituality and cultural teachings and practices, such as the Seven Sacred Teachings, smudging and prayer, sweat lodges and traditional medicines.

Treatment Opportunities

- A First Nations-specific detox is needed. Investigate One Connections community detox via Grand Chief Michael Mitchell - Expand the use of day programs. - More study and support options are needed for prescription drug abuse.

4. Harm Reduction

Methadone Observations

- Methadone is a synthetic opioid used as a replacement for individuals who are opioid dependent. Methadone therapy is considered a harm reduction approach. - Most people need treatment interventions, counselling, a recovery plan and support to move beyond addiction. Methadone can be a helpful first step on the road to recovery but the use of methadone alone should be considered a last resort. People are put on methadone too readily, before more complete options and support needs are explored. It is also hard for many people to get off methadone, for many reasons. - An increasing number of First Nations individuals are using methadone treatment. - Methadone is prescribed to pregnant women who are opioid dependent. Some people feel that methadone affects the health of the unborn child and will have negative health implications for the baby. Others caution that the outcome should be compared with what the child would be like if the mother continued to use drugs. - Methadone and NADACA: Methadone is a drug and people must be drug- free before attending NADACA treatment centres, which follow an abstinence-based model. The need for people to be drug free before going to treatment is supported by the Elders. - People are, however, able to use methadone and take part in NADACA day programs/outpatient programs. For example, 90% of those in Rising Sun day programs are on methadone. - NIHB and transportation barriers make it challenging for methadone users to get their methadone treatment. NIHB pays for transportation but only for the first 4 months of use. Childcare is also a similar barrier for those who need to take methadone daily.

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- Suboxone is a new drug that works in a similar was to methadone. It is easier to stop than methadone and access is easier because it is taken every three days, not daily. It is more costly, depending on how that is measured. Dispensing fees are high for methadone but the drug cost is $5/month. Suboxone costs $70/week but comes in packet form (low dispensing fee). Suboxone cannot be used when pregnant. Doctors are reluctant to prescribe Suboxone. - There is a need to support individuals using methadone while still valuing the abstinence-based models of treatment centres

Needle Exchange

- Used needles from drug abuse and diabetes are also a risk due to Hep C and AIDS. There are high rates of Hep C in the Miramichi region and in Cape Breton.

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Special Meeting of the Mi’kmaq Maliseet Atlantic Health Board (MMAHB) Health Information Management for Atlantic First Nations Communities March 5-6, 2013 Holiday Inn, Harbourview Dartmouth Nova Scotia

Monday, March 4, 2013 PHSCD Steering Committee to Attend. Not for MMAHB

9:30 – 10:00 Welcome and Introductions

10:00 – 12:00 PHSCD Evaluation Presentation of Key Findings and Validation Exercise. Rob Assels

12:00 – 1:00 Lunch

1:00 – 3:30 Facilitated Discussions Related to Sustainability: What are communities doing now? What are the next steps? How will health status indicator data collection continue? Health Information Management Sustainability and Health Planning Beth Lewis

3:30 – 3:45 What to Expect from Tomorrow

3:45 – 4:00 Wrap Up and Closing

Tuesday, March 5, 2013 MMAHB to attend

9:00 – 9:30 Welcome, Introductions, and Purpose of the Meeting

9:30 – 10:15 Regional Health Survey (RHS): Data collection; community access; use of data RHS for Nova Scotia and Newfoundland

10:15 – 10:30 Nutrition Break

10:30 – 11:15 FNIHB: Data collection/availability; community access; use of data Regional Epidemiologist, FNIHB-AR

11:15 – 12:00 Communities: Data collection; access; use of data

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Community representatives

12:00 – 1:00 Lunch

1:00 – 1:30 Review and Questions from the morning

1:30 – 2:45 Where Do We Want to Go? How can communities be supported in data collection and access efforts? How do we work together for the benefit of communities? Group discussion

2:45 – 3:00 Nutrition Break

3:00 – 3:45 Bright Spots! Stories of success on data collection and use from community projects

3:45 – 4:00 Review of Day One Facilitator

Wednesday, March 6, 2013 MMAHB to Attend

Discussion Question: What are the data opportunities that can be maximized to help the Health Advisory Committees make progress in meeting the Chiefs’ health priorities?

9:00 – 9:45 Mental Health

9:45 – 10:15 Addictions

10:15 – 10:30 Nutrition Break

10:30 – 11:15 Elder Care

11:15 – 12:00 Investing in Children and Youth

12:00 – 12:15 Wrap Up and Closing.

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MMAHB-HIM Meeting Holiday Inn Dartmouth March 5-6, 2013

MMAHB Members Present Attendees: Representing: Chief Aaron Sock MAWIW Chief Andrea Paul CMM Proxy Chief Noel Joe Miawpukek

Non-voting Members Present Chief Deborah APC/NS Co-Chair Elaine Allison Wagmatcook Robinson John Paul APC Jennifer MacDonald Waycobah Amanda Peters APC Stacey Lewis Tui’kn Chelsea Googoo APC Barbara Broom FNIHB Nilan Marshall MMAYC Co-Chair Beth Lewis FNIHB Roseanne Sark MCPEI Jennifer Ross- FNIHB Makhan Margaret Jadis APC-MCPEI Elder Agatha Hopkins FNIHB Tanya Poulette Membertou Andrealiza Belzer FNIHB Eva Sock Elsipogtog Kelly Bower FNIHB Maggie Organ Miawpukek Gillian Bailey FNIHB Tasha Sock Elsipogtog Louise Cholock FNIHB Sally Johnson UNSI Glenda Rosborough FNIHB

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Gerald Gloade UNSI Robyn Boychuck FNIHB

MMAHB members & Non-voting members absent Chief Candice Paul UNBI Grand Chief Ben Mi’kmaq Nation Sylliboy Chief Norman Bernard UNSI Janet Pothier CMM Chief Brian Francis MCPEI Sandra Musgrave FNIHB Debra Keays-White FNIHB Morley Googoo AFN Roger Augustine AFN

Agenda Items Notes Actions Day 1: - Amanda welcomed the group and explained the reason Welcome & behind the HIM meeting. The meeting had been in Introductions: planning stages for a long time since the Chiefs wanted to see data collection on FN health issues. RHS: Data collection; - UNSI Stats Analyst Gerald Gloade and Sally Johnson #1: Amanda will speak to Sally community access; made a presentation on the amount of data collected for from UNSI and to UNBI about NS and the RHS. So far there have been 1500 surveys having the RHS revisiting the Newfoundland: completed in NS and 6 in NB. There is not enough idea of having surveys to be funding to do visit each community to collect data. completed throughout the Questions arose around the area of RHS not being entire Atlantic Region. available in NB. For anyone who wants more information about the RHS in NB is to contact Peter Birney and #2: Jennifer Ross-Makhan Sarah Rose from UNBI about RHS. The Mi’kmaq Ethics announced if anyone wants Watch Committee keeps an eye on surveying the help on the NIHB data she is communities in the Atlantic Region. NB would like to offering any assistance. have RHS in the NB communities not only have it in Tobique. There was confusion about “region” means with the RHS acronym, Sally said it’s the national office that calls region per province. There was interest at the table to have RHS include the entire Atlantic Region, not

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Agenda Items Notes Actions just particular communities throughout the Atlantic Region. FNIHB: Data - Any data from FNIHB can be given to the communities Collection/Availability: on request. All the communities are open for feedback Glenda Rosborough and for help and assistance to make any changes with the tracking tools. The dental database shows results of how many communities’ are using the dental services. - Feedback: many people agreed saying the CBRT is not user friendly for the communities, it is long at 57 pages and it needs to be changed and updated. - Glenda added out of 17 communities who use the CBRT, there are only 8 that use the tools. She added the fact it is a new program and it will take some time to get used to it, some communities may want to use Excel where the tools are all set up to make it easier. - Agatha: the CBRT process is needed as it is the only piece linked to the funding agreements. Health Canada is looking at ways in trying to simplify the tool. - John Paul asked about the future plans of combining FNIHB and AANDC funding agreements in the next few years. John also added if things are complicated now with the funding agreements it will be worse and confusing when 2 federal departments are combined. - Discussion on who can access the communities’ data. Glenda said the request has to come from a health director or from a Chief. The protocol is through the health directory only. Communities: Data - Elsipogtog Community: HIS came along with better #3: Sally will follow up with collection; access; electronic medical records but the tracking tools are a Eva Sock about the RHS use of data disappointment. If it the tools were better more people policies that are already Community would be using them. EMR is another challenge as it developed if Elsipogtog is Representatives requires privacy and many health center employees have interested to use the RHS

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Agenda Items Notes Actions access to the EMR. There is a privacy policy in place but information. Sally will first there will be a 2 day privacy and policy workshop for the have to speak to the national health center employees soon. office coordinator. - Miawpukek Community: there will be a 6 fact sheet of data to be released soon for the Newfoundland and Labrador communities. Review and Questions - Beth Lewis created 3 charts to capture the morning from the Morning: session: 1.) RHS: - Regional – NS/NL/PEI/Tobique and NB is separate - Different approaches depending on area/province - Emphasis on privacy & consent - Community projects: larger communities can have individual reports, harder for smaller ones - Request from community – BCR - Next survey will include “community profiles” – housing, food security, etc. 2.) FNIHB: - Epi’s use data already collected for reports - Health status reports created annually - Communities can request their health status (from HDs) - Epi’s can provide reports that are customized to audience and intentions/use (HDs) - Organizations could use this data – liaise with provinces, etc. Current protocol is request from HDs - Watchful of impact of AANDC-FNIHB Fas 3.) Communities: - Data sharing and provinces is technically easy but takes time due to privacy, etc. - OCAP followed communities’ own reports - “Epi-boot camp” to develop capacity beyond data entry - Health bulletins provide snap shop info to support health

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Agenda Items Notes Actions planning - Integrate indicators into health plan - Extend EMR to other programs - Sharing with other communities (privacy, EMR work, etc). - HIM team in community - Communities need to tell their story Where do we want to - Many people/organizations are interested in the #4: UNBI was not present at go? collection of the RHS data. Harvard University is looking the meeting and they hold the into reviewing RHS. RHS funding in NB therefore - Discussion around including NB to be added into the this issue will be tabled at the RHS data: discussion around the gaps and problems next MMAHB meeting. linked from the provinces and the communities. - Leadership in the Atlantic have to stand up and work together in order for the RHS to work out completely throughout the region and to include all Atlantic provinces’ communities. - Many people agreed the communities need to benefit from data collection but funding for better technology is also needed. - Some ideas about technology around the table were: connecting with Apple and using their Icloud program for health centers’ and communities to share the data. Bright Spots! - Elsipogtog Health Center: now have privacy policies in place; working group committee created; more communications with the Province Commissioner; retrieving info from the EMR to find gaps and pieces to work with the hospitals; training with physicians is creating a better working relationship; 2 year accreditation on data collection is in the works. - Tui’kn: had created an awesome fact sheet and it will be posted on the Tui’kn website as well as the website of

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Agenda Items Notes Actions the DHA. - Miawpukek: Circle Project about diabetes has been completed and the annual report will be given to the Chiefs and communities (a collection of data for yearend accumulation. - Chief Andrea suggested that our communities’ have teen help centers to promote healthy living and to practice safe sex. Sally said HON is available to host workshops on anything requested. Review of Day One: - Facilitator Beth Lewis created 2 posters: #5: John Paul suggested for Where do we want to go?: the MMAHB to have a working - Pursue core funding (critical during this stage). group with information about - Build provincial relationships. data collection (RHS data, - Unify RHS/REES- region-province-community. NIHB data and real time data). - Using/reading results workshop for communities (FNIHB, RHS, communities). - Get ahead of the tech curve (instead of always catching up). - Maximize use of EPI’s and directed by a MMAHB subgroup. - Legal and tech expertise is needed. Communities BRIGHT SPOTS: - Data sharing & provinces is technically easy but takes time due to privacy, etc. - OCAP followed communities’ own reports. - “Epi-boot camp” to develop capacity beyond data entry - Health bulletins provide “snap shot” info to support health planning. - Integrate indicators into health plan. - Extend EMR to other programs (HDs). - Sharing with other communities (privacy, EMR work, etc).

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Agenda Items Notes Actions - HIM Team in community. - Communities need to tell their story. Day 2: Beth Lewis - Discussion Question: What are the data (FNIHB Facilitator opportunities that can be maximized to help the made charts on the 4 Health Advisory Committees make progress in Health Priorities of the meeting the Chiefs’ health priorities? Chiefs: - Robyn Boychuck, FNIHB Policy Analyst: gave an overview on how the MMAHB works and as the decision maker. Mental Health: - Poor quality indicators in CBRT for MH (mainly referrals) #6: Actions for mental – not health status. Not NNADAP, province, etc. wellness health: - RHS better source of information Look at RHAs/hospitals for - Referral forms would be better source (de-identified) (no more data or look at data by access by EPI’s) postal code.  NEED QUALITY/SOURCES OF MH HEALTH STATUS Delivering mental health DATA counselling in the community - Mental health and/or addictions tracking tools for data at – there is no tracking tool at the community level this moment. Eskasoni - Can nurses use “Sassi” (mental health centers) and mental health and social work distribute to HD’s and discuss have a tracking tool. - Won’t be able to get information on all MH referrals Gerald offered if anything is (province, etc.) could access some through the data. needed from RHS. - Tools/forms need to be shared Kelly added the idea to - Most data collected for MH&A is on paper develop a mental wellness - National project to use ‘AMI’ – elec? Database for MH&A tracking tool – links to CBRT and to EMR?  Maximize use of RHS (share with MW committee) #7: Sally will bring the RHS - MTRS/NIHB data as a source for MH&A data regional results to the MH - Anti-depressants data from (NIHB) committee meeting in April. - HSIF/AHTF project reports - IRS data (not in CBRT) - Aboriginal Healing Foundation

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Agenda Items Notes Actions - LHS data - Mental wellness teams - Infant mental health (keep on?) - Not data sources but tells a story Addictions: - Prescribing review & working with doctors based on rates. - Any kind of data collected needs to have permission by the Chiefs (for involvement about what is going on) - For each committee and work plans, how do we support the Chiefs, Chief Andrea loves the Tuikn fact sheet – wants to see the results and actions first hand - All Chief and Council need to be included in the work to ensure the support (mental wellness committee communication and community leadership – beyond the health center – all communities to communities - Improve communications from the committees work to the communities (especially the leadership) - NNADAP data has lots of potential (try to find ways for reporting back to the communities – conflict in confidentiality?) - Drug use strategy – maximize community access to NIHB data. - Gathering to share success of addictions projects - Reports that come to FNIHB - MW committee to review possibilities of NNADAP data - Linkages back to prevention - Maternal drug use (babies born to a mother using) data from MCH data but linkages back to MS like: C&Y, FASD, AHSOR, family services and education - Other ways of knowing – ensuring that information isn’t lost just because its’ not data Elder Care: - Data around rejected claims/pharmacy follow up on “non-

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Agenda Items Notes Actions benefit” Rx – NIHB data analysis - Patient/client navigators (one in CB and one in HRM) – band paid. Data?: RHS to report on access for elders, request from PHPC committee (CB gets stats each year; CB can share with communities). - Long term care stats? CMM/AADNC data/NS/NL/PEI/NB - CBRT? X - eSDRT – include data on elders who need long term care - Adult protection data (have to go to hospital before province AP comes in) – Prov records? Can communities access? - IRS data to show how elders are - Falls-causes – Data? - Benzos/opiods use in elders

Children & Youth: - School data - Teen health centre data - Mi’kmaq Family data - Youth treatment (CJ Andrews and Quebec) – MTRS: travel - Children with disabilities, data: proxy – NIHB: wheelchairs and medications, etc. - Respite care - Development delay/screening and on mat/ch tracking tool - Childhood obesity (who) on mat/ch tracking tool - Hearing and speech screening – follow up data - FN school worker for off rez schools – data on cases - Autism data – there is this traced? Increases related to ADHD or FASD? - Cultural interventions data of ceremonies, etc with

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children & youth - Children in care: AANDC included in HSR (linked to?) - It takes a community to raise a child - COHI-children’s oral health initiative - Specific data/indicators to focus on prevention initiatives: analysis, telling the story of the children and youth - Proactive measures for children and youth – data at community level – CBRT - Sharing of data between C&Y departments in the communities like: daycare, AHSOR, MCH, etc. - IWK Choices – NIHB Data like travel - RHS/REES data - Sally suggested once we get all this data from the C&Y what are the next steps, what are we going to do with all this information?

Closing: There was a roundtable at the end of the meeting where everyone had a chance to speak about the 2 day HIM-MMAHB meeting.

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Health Tech’s Agenda June 18, 2012 Crowne Plaza, Moncton NB

Welcome and Opening Prayer

Review of Agenda

Review and approval of minutes. Review of Action Items

Roundtable

New Business  Review the MMAHB Agenda  Review Committee Reports to MMAHB  Update on MMAHB Evaluation, Orientation Manual, etc.  Update on issues associated with Health Canada funding cuts

Funding cuts implications-action plan

Closing

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Health Techs Meeting Crowne Plaza Hotel, NB June 18, 2012

Attendees:

Sally Johnson Loraine Etter Roseanne Sark Peter Birney Janet Pothier Amanda Peters Chelsea Googoo

Regrets: Laurie Nicholas

1.) Welcome and Opening Prayer: Amanda Peters welcomed the health techs to the meeting and there was no opening prayer as Sally Johnson did an opening prayer for the co-chairs during the morning meeting.

2.) Review of Agenda: Agenda has been approved by consensus by the health techs.

3.) Review and approval of minutes. Review of Action Items:

Review and Approval of March 21 Minutes…review of action items: No minutes to review since none were taken.

Note: Under new business agenda item: Peter will add the FNIHB Strategies.

4.) Roundtable:

Sally Johnson, UNSI:

Sally attended the national health technicians meeting in Ottawa, Ontario during the week of June 11-15, 2012. She met with Valerie Gideon and they discussed the national cutbacks. Both Paqtn’kek and Pictou Landing are now sharing a psychologist and the province of NS is covering the financial costs. UNSI is in the middle of hiring a

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REES Coordinator and a Data Analyst. Sally spoke to elder John Joe Sark about her concerns with the federal cutbacks since now is only the first wave she wants the leadership to play a bigger role, especially in the health areas. In Ontario the tribal organizations are now being asked to show in detail about the 10% administration fee. Sally said we have to look at the programs there are going to sunset, many in 2015.

Action Item #1: Sally will send Chelsea the document called, on the Public Health pilot project and another link to a science class, and email it to the health techs.

Roseanne Sark, MCPEI:

Roseanne brought hard copies of her health tech update to the meeting. See her report for more information on her latest set of meetings.

Peter Birney, UNBI:

Peter brought hard copies of his health tech update on the following areas:

- National Issues through the restructuring of AFN and the Mental Wellness update. - Provincial/Regional issues around HSIF, CDC Workshops, NB FN Provincial Health Advisory Committee, NB Environmental Health Working Group and the methadone maintenance, counseling and impact assessment.

Janet Pothier, CMM:

Janet gave an update on the NS provincial update with the possible changes to the pharmacy association not to make direct payments to the government for the pharmacy medical drugs and the deadline of negotiations is July 1, 2012. If the negotiations stop then FN people will have to pay out of their own pockets for the pharmacy medical drugs and wait for a reimbursement by Health Canada.

Janet’s idea is to utilize the Upper government level of the Opposition (NDP) so they will know and they will question the Conservatives party during Question Period.

Action Item #2: Roseanne’s suggestion is to have a special health tech meeting and bring the right people to the table, including the MMAHB Chiefs and Amanda, using their own T.O. money. Action for Amanda: to look into the available funds to host a health tech meeting. The meeting is to lay down strategies around the idea to integrate with the Chiefs regarding the health policy areas on the federal cut backs.

5.) New Business:

Amanda Peters - Update on MMAHB Evaluation, Orientation Manual:

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Amanda received some feedback from a few health techs on the new NIHB committee’s TOR. Chief Darlene Bernard will bring up the issue for discussion questions during the MMAHB meeting on June 19. If they are approved, then they (Amanda and Robyn) will re-write the TOR for the other MMAHB subcommittees. There was discussion around the possibility of the provincial integration, but the health techs said it should not be done through the MMAHB level. The Orientation Manual will look more like a how-to guide. With the budget cutbacks, the subcommittee meetings may have to take place during a teleconference meeting only.

The new MMAHB will look like: having 7 members: Debra Keays-White and 6 Chiefs, 1 FNIHB director and their non-voting policy support. The entire cycle will work much better: subcommittees first meet then the MMAHB then the health directors x 3 times a year. The meetings will be known ahead of time. There will be a template package for each person as well. The health techs will be the ones to nominate who they want to sit as a rep for each subcommittee.

Discussion around the MMAHB newsletter, many feel it is a good idea and it would serve to have better communications, since it is much needed.

Update on issues associated with Health Canada funding cuts:

Discussion around the table with the health techs about the funding cuts per organization. Everyone is discouraged about the funding cuts.

Roseanne’s suggestion: to bring AAEDIRP people to the table to inter-connect with AAEDIRP’s research project on health, social, economic development connections: social determinants of health.

Closing Prayer: Sally Johnson

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Health Technicians Agenda October 17, 2012 APC Head Office, Dartmouth, NS 1:00pm – 4:00pm 6:30pm – 8:00pm

1:00pm - 1:15pm Welcome and Opening Prayer

1:15pm – 1:30pm Review of Agenda

1:30pm – 1:45pm Review and Approval of Minutes. Review of Action Items

1:45pm – 3:15pm Review of the MMAHB Agenda

Review Committee Reports to MMAHB

Issues for the First Nations Caucus

3:15pm – 3:45pm New Business

3:45pm – 4:00pm Closing

6:30pm – 8:00pm First Nations Caucus with MMAHB Chiefs (tentative)

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Health Techs Meeting October 17, 2012 APC Head Office, Dartmouth, Nova Scotia

Attendees: Amanda Peters, Sally Johnson, Roseanne Sark, Chelsea Googoo

Regrets: Peter Birney, Laurie Nicholas, Janet Pothier

Agenda Items Notes Actions Welcome/Opening:  Amanda welcomed Roseanne and Sally. Review of Agenda  Passed. Review and approval  Minutes have been approved. Review of action item of minutes and action #1: to delete from items. notes, Sally will follow up. Action Item #2: did not happen. Review of the MMAHB  No questions or comments on the Agenda agenda. Review Committee  The 3 reports were placed in the Reports to the Health Techs packages. MMAHB Issues for FN Caucus  Cancelled New Business  FN Caucus with  Cancelled MMAHB Chiefs

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Health Technicians Meeting Membertou Trade & Convention Center January 14, 2013

Attendees: Representing:

Laurie Nicholas MAWIW Amanda Peters APC Roseanne Sark MCPEI Janet Pothier CMM Chelsea Googoo APC

Regrets: Sally Johnson and Peter Birney

Agenda Items Notes Actions No agenda to  The health techs are to meet with the review Chiefs during the evening hours to discuss the MMAHB agenda and any issues to follow up on.  The health techs would like to know which committee will house the Elder’s strategy, some agreed that it should be the NIHB committee to take the lead. Transition Plan  Amanda reviewed the transition plan To be presented to with the health techs and many the Chiefs at the questions arose about the transition evening First Nations plan. caucus MMAHB  The health techs reviewed the agenda MMAHB agenda. Closing  The health techs closed the meeting and have plans to have a Caucus meeting with the Chiefs.

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Co-Chairs Agenda June 18, 2012 Crowne Plaza, Moncton NB 2:00pm – 4:30pm

2:00am - 2:15pm Welcome and Opening Prayer

2:15pm – 2:30pm Review of Agenda

2:30pm – 2:45pm Review and Approval of Minutes. Review of Action Items

2:45pm – 3:30pm Roundtable

3:30pm – 4:15pm New Business

- Review the MMAHB Agenda - Review Committee Reports to MMAHB - Update on MMAHB Evaluation, Orientation Manual - Update on issues associated with Health Canada funding cuts

4:15pm – 4:30pm Closing

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Co-Chairs Meeting-Minutes Crowne Plaza, Moncton June 18, 2012

Attendees:

James McGrath Amanda Peters Sally Johnson Susan Ross Chelsea Googoo

Regrets: Laurie Nicholas, Janet Pothier, Charmane Kay

1.) Welcome and Opening Prayer: Sally Johnson

2.) Review/approval of agenda: passed by consensus; Breakfast at Parliament added to the agenda by Sally Johnson

3.) Review of March 2012 Action Items/Minutes:

Action Item #1: Amanda will follow up with UNBI for the PHC & PH representative. #1: Completed.

Action item #2: Amanda to work with Wade Were from FNIHB to get the MMAHB in camera session for FN on the next agenda. #2: Completed.

Action Item #3: Amanda to look into setting up a group site on the HHP website. #3: On going.

Action Items #4: Loraine to send out email. #4: Not completed; Amanda will follow up.

Note: Minutes are passed with the deletion of the discussion around Assisted Living (last page). 4.) Roundtable:

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Child & Youth Co-Chairs James McGrath & Sally Johnson:

- Validation of the C&Y Priority Setting survey results. - Discussion and input from the committee on the core elements and outline for the child and youth strategy. - Process for developing the child and youth strategic action plan. - FASD program funding from 2013-1015 discussion. - Status of action on MMAHB directive for the child and youth strategy. - Current issues and recommendations for MMAHB: FASD program funding issues but the majority was with the Option #1 of status quo. - Achievements since the last meeting.

PHC Co-Chair Susan Ross:

- Susan gave a brief update and provided copies from the last PHC subcommittee meeting. - The quality improvement, home care framework, developed resources and many volunteers such as the FN health techs are part of it, it will occur the last week of September 2012. - No issues or actions taken to the MMAHB.

Action #1: Susan will send Amanda more information on the Quality Improvement.

Amanda Peters, APC:

For consideration: TRI-HAC/AGA for the following groups: MMAHB, subcommittee co- chairs and the health technicians, FN members and FNIHB to all meet for 1 day.

5.) New Business:

- Review of the MMAHB Agenda. - Review of the committee reports to MMAHB. - Update on MMAHB Evaluation, Orientation Manual etc. - Update on issues associated with Health Canada funding cuts.

Breakfast at Parliament Hill, Sally Johnson’s FNIGC Meeting:

This meeting was to launch on the report of the RHS survey from 2009-2010. Sally passed around the table her folder she received from the meeting.

6.) Closing: Remarks by Sally Johnson

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Co-Chairs Agenda October 17, 2012 APC Head Office, Dartmouth, NS 9:30am – 12:00pm

9:30am - 9:45am Welcome and Opening Prayer

9:45am – 10:00am Review of Agenda

10:00am – 10:30am Review and Approval of Minutes. Review of Action Items

10:30am – 11:00am Roundtable

11:00am – 12:15pm New Business

- Review the MMAHB Agenda - Review Committee Reports to MMAHB - Update on MMAHB Evaluation - Update on issues associated with HC funding cuts - DUPP Funding 2012-13 - Federal Tobacco Control Strategy - Restructure of Co-chairs and Co-Chairs resignation

12:15pm – 1:00pm Closing and Lunch Provided

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Co-chair Meeting

October 17, 2012

APC Head Office, Dartmouth, Nova Scotia

Attendees: James McGrath, Charmane Kay, Sally Johnson, Amanda Peters, Susan Ross.

Regrets: Laurie Nicholas and Janet Pothier

Agenda Items Notes Actions Opening Prayer  Sally Johnson opened the meeting with a prayer. Reviewing the  Passed, no changes. agenda Reviewing the  Action Item #1: Completed; Action Amanda will follow up Minutes Item #4 from the March 2012 with the action item #4 minutes will follow up by Amanda. under the March 2012  The co-chairs passed the minutes. minutes. New Business:  The co-chairs reviewed the MMAHB. Review the  MMAHB Agenda New Business:  No action required for the MMAHB. Susan will follow up with Review Committee  Sally asked about the EHO working Kelvin for Sally about Reports to group with FNIHB. the involvement with a MMAHB First Nations group on  Sally asked about the ongoing files (PHC & PH): the EHO. and concerns on the independent Susan will contact study made on the Eskasoni Crisis Kelvin via email and cc Center with the PHC/EHO. Sally for further information. New Business:  Charmane gave an overview on the Charmane will send Review Committee wellness update. Chelsea the IRS update Reports to  No action required for the MMAHB. from FNIHB for a MMAHB placement in MMAHB  An audit will be provided for IRS. (Wellness): packages. New Business:  James read aloud and gave an Chelsea will print 10

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Agenda Items Notes Actions Review Committee overview on the C&Y update. copies in color of the Reports to C&Y Strategic Plan for MMAHB (C&Y): the MMAHB to review on Oct 18/19. New Business:  Amanda discussed the MMAHB Amanda and/or Chelsea Update on membership letter and it will be going will be sending out the MMAHB out the following week to the Chiefs MMAHB membership Evaluation: and the health techs as per tribal letter the week of organization. October 22-26, 2012. New Business:  Note: this will be removed from the This item will be Update on issues agenda removed from the associated with agenda. HC funding cuts. New Business:  This DUPP decision went to a vote to DUPP Funding the MMAHB. The RFP will go to the 2012-13 wellness committee via teleconference on Oct. 22 for more discussion, its’ for $184,000. New Business:  This strategy will go to the tribal Federal Tobacco organizations instead of the Control Strategy communities.  The last strategy meeting was a success and it had a good turn out by representatives from the tribal organizations and from FNIHB. New Business:  Amanda previously discussed this Restructure of Co- agenda while discussing the MMAHB Chairs & Co- membership. Chairs resignation Closing Remarks:  Amanda Peters closed the meeting.

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Co-chairs Meeting Membertou Trade & Convention Center January 14, 2013

Attendees: Representing:

Louise Cholock FNIHB Leila Gillis FNIHB Roseanne Sark MCPEI Janet Pothier CMM Chelsea Googoo APC

Regrets: Gillian Bailey and Sally Johnson

Agenda Items Notes Actions Opening  Roseanne Sark Prayer Co-chairs  The co-chairs of the mental wellness report: Mental committee are Gillian Bailey from FNIHB Wellness and Janet Pothier from CMM.  Issue: DUPP funding for 2102-2013 will be addressed to the MMAHB.  Work plan in progress and will be completed before the MMAHB meets in May 2013.  Recommendation for MMAHB: to have a Gathering in the new fiscal year of 2013, funding will come from the DUPP.  The co-chairs will present to the RAPC in seeking a permanent observer to sit on the mental wellness committee table. Co-chairs  The co-chairs are Leila Gillis and Report: Public Roseanne Sark. Health and  The work plan is in progress and will be Primary Care completed before the MMAHB meets in May 2013.

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Agenda Items Notes Actions  Issue: which committee should house the Elder’s care strategy? Co-chairs  The co-chairs are Louise Cholock and Report: Sally Johnson. NIHB  The work plan is in progress and will be completed before the MMAHB meets in May 2013.  Issue: which committee should house the Elder’s Care Strategy?  The elder care working group would like to host an Elder’s Conference possibly in June (pending on funding). Review of the  The MMAHB Coordinator read the MMAHB agenda to the co-chairs. There were no Agenda: copies to distribute. Closing:  The co-chairs closed the meeting for lunch.

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PHC&PH Meeting

May 8, 2012

MCPEI Boardroom Summerside ,PEI

Draft Agenda Topics

May 8,2012 9:00 am Opening Prayer Welcome and Opening Remarks Review and Approval Agenda Review/approval Minutes

Follow up actions, Updates (all) 1030 am Break 1045 am Updates (all) 12:00 pm Lunch 1:00 pm MCPEI Update and PEI tripartite activities– Rosanne Sark 1:30 pm HAC evaluation update- Amanda Peters 1:45 pm PH/PHC workplan 2:30 pm Break 2:45 pm Communication Plan 3:30 pm Input for PHC & PH Subcommittee Report for next MMHAB meeting(June 19/12) – Co-chairs, Susan and Laurie 3:45 pm Closing Prayer

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PHC & PH Committee Meeting May 8, 2012 MCPEI Office, Summerside, PEI Attendees:

Laurie Nicholas, MAWIW; Co-chair Susan Ross, FNIHB; Co-chair Leila Gillis, FNIHB Kelvin Latham, FNIHB Roseanne Sark , MCPEI Loraine Etter, APC Elaine Wilson, FNIHB; Observer Linda McCallum, FNIHB Paula Robinson, APC; Observer Chelsea Googoo, APC Elaina Bigras, UNBI Jacki MacDonald, FNIHB

Regrets: Brenda Roos, Janet Pothier, Elaine Allison, Gillian Bailey.

1.) Opening Prayer: Roseanne Sark

2.) Welcome and Opening Remarks: Co-chairs Laurie Nicholas and Susan Ross

3.) Review and approval agenda: approved by consensus.

4.) Review/approval Minutes: Minutes have been approved by Roseanne Sark and seconded by Jacki MacDonald

5.) Follow up actions, Updates (all):

- Completed. - In progress. - Jacki follow up - Completed.

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- Completed. - Follow up with Amanda for the next meeting.

Action Item #1: Laurie will follow up with Matthew Pryde on a report he presented on at a previous meeting.

6.) Updates (All):

Kelvin Latham: Kelvin has been doing radon testing in some communities. In some cases, more equipment has been put in a few communities in NB. Kelvin does monthly visits to the communities and people can call him to ask him questions anytime.

Action Item #2: Laurie asked Kelvin about how many communities are affected with high radon levels, Kelvin will follow up.

Action Item #3: Chelsea will send Kelvin’s update electronically to Roseanne.

Leila Gillis: Leila’s update: see hard copy for more information. It is National Nurses Week. The RFP for the Nurses Conference will go out before the end of May. The conference will most likely be held in Moncton, NB. Sept. 17-20 workshops week, targeted audience will be nurses and health directors from NB.

Action Item #4: Leila will ask Brenda Roos to forward some document to Laurie, will ask Laurie.

7.) MCPEI Update and PEI Tripartite activities – Roseanne Sark:

Roseanne asked for the PEI communities to have their own electronic medical records. Roseanne said the communities are asking about it, they want to manage their own data.

PE’s HSIF projects have been approved and are just waiting for the contribution agreements. There is concern that without the capacity dollars FN people would not be able to attend the projects meetings as they don’t have the travel budget. Therefore there is a further concern that the projects will look like a provincial/federally driven project.

Note: Louise Cholock called in via teleconference and provided the NIHB update from FNIHB. Note: to provide the best and the most accurate NIHB update, Louise’s update has been copy/pasted to this document:

NIHB update for PHC and PH HAC May 8th, 2012

Pharmacy:

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a) One new topic is the availability of new smoking cessation documents -posters, checklists re readiness to quit, and listings of the drug products that are available on the NIHB Drug Benefit List (DBL). These were developed as joint venture with First Nations and CADTH (Canadian Agency for Drugs and Technologies in Health). Lots of copies available in Regional office for distribution. If you have ideas for distribution methods that could be helpful- we are planning to mail out a package to each community.

Kathleen is also planning on doing a videoconference on the topic on May 17th.

B) Please be advised that effective May 7th, 2012 (yesterday) , Levemir insulin (insulin determir) is an open benefit in the Non-Insured Health Benefits Program. Levemir is a long acting insulin which is similar to Lantus insulin. Lantus is also available as an open benefit.

C) Effective Monday March 12th, Methadone became a limited use (LU) benefit in Nova Scotia, PEI and Newfoundland/Labrador (previously an open benefit). You may recall we made this change in New Brunswick back in August. The main LU criterion is for clients to be restricted to one prescribing doctor for methadone and all other opioids and benzos. For now, this will only affect new clients starting on methadone. Clients already on methadone will continue to have uninterrupted coverage. “NIHB clients already receiving methadone for opioid dependence prior to March 12, 2012, will be grandfathered as to not interrupt their methadone maintenance therapy. However, the NIHB Program will work with the client’s treating physician and pharmacist to ensure they meet these new LU criteria within an appropriate time frame”

d) Therapeutic Formularies (note sent to the HD’s May 4th and also sent to Susan Ross and Marc Beaudry for distribution to HCC nurses)

These color-coded "therapeutic formularies", indicate which drugs:  are available as open benefits, (green)  require the pharmacy to call the Drug Exception Center, (yellow)  require the client to go directly through the appeals procedure, (orange)  are exclusions of the program and not subject to appeal (red)

The treatment areas addressed in the documents attached are:  diabetes  GI reflux disease (e.g. heartburn, other stomach problems)  depression  lung diseases (asthma, Chronic Obstructive Pulmonary Disease -COPD)  osteoarthritis  rheumatoid arthritis

Medical Transportation:

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a) Due to misinterpretation of the Medical Transportation Policy Framework by the Regional Office, there has been a change in the medical transportation benefit.

Effective April 30, 2012 NIHB will cover the most economical and efficient means of transportation, taking into consideration the urgency of the situation and the client's medical condition. If a client chooses to travel by private vehicle (either drive themselves or have someone else drive), the client will be approved for mileage when this is the most economical mode. Meals and accommodations for the client only will be covered if specific criteria are met. Meals and Accommodations will not be covered for the driver.

A Non-Medical Escort will only be approved if specific criteria are met. The Non- Medical Escort is required to stay in the same room as the client. Meals would be covered for the Non-Medical Escort (if approved).

(a memo to clarify this was sent out to HD, Navigators and medical Transportation workers in the community April 27th, 2012)

b) Elder Care working group update: have supported the development of a tool or lens to review programs to make sure the programs are supportive for Elders. MT was the first program to be reviewed. Just finalizing the work and recommendations from the review. Still need to be discussed at RLT May 11th, 2012, with MMAHB ( and HACS) and All Chiefs

Vision: Working on Vision Provider Kit and info sheet for clients (March 31,2013)

Medical Supplies and Equipment: Looking to streamline processes: a) Orthotics project Sept 2012 b) Work with QC NIHB program and their RN to review specific benefit areas such as dressings

Note: Continued updates:

Elaina Bigras: Elaina is discouraged to hear about the cancellation of the Health Careers for this summer. Kevin Ryan had recently informed Elaina that the National Health Careers have been cut. Larry Whiteduck from AFN has been laid off. Home care needs assessment, at the community level, give nurses the skills and the tools, instead of the politics on the reserve always plays a big role, FNIHB needs to crack down on a stricter policy. There is a new Home Care nurse in St. Mary’s.

Paula Robinson: Diabetes drugs and new benefits have been recently approved. Busy with incoming calls.

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Action Item #5: Susan will take back to Louise, the question regarding on Qalipu and Bill C-3 clients information. (Susan please add the information/question to this action item).

8.) HAC evaluation update – Amanda Peters:

Amanda Peters: HAC evaluation: Major funding cuts at APC’s health department, the status of the Health Conference, the Health Directors meetings and the MMAHB is unknown. The MMAHB evaluation is on hold for now. The Orientation Manual is on hold as well. The child and youth strategy is being developed, including a survey (which is going live tomorrow). The survey is online and it takes 20 minutes to take, Amanda is encouraging everyone to use it. The MMAHB is held on June 19 in Moncton at the Crowne Plaza.

Action Item #6: Chelsea will email the letter to the Minister of Health and the Media Release written by John Paul.

Linda McCallum Update (Update is provided in hard copy)

Loraine Etter Update (Update is provided in hard copy)

Laurie Nicholas Update (Update is provided)

Roseanne Sark (Update is provided)

Susan Ross (Update is provided)

9.) PHC/PH work plan:

The work plan is on hold for now, will revisit at the next meeting.

10.) Communication Plan:

Communication Plan discussion around the following action item:

Roseanne wants to know the process of how to get on to the MMAHB agenda as a committee.

11.) Input for PHC & PH Subcomittee report for the next MMAHB meeting:

Action Item #7: The co-chairs requested for the committee members to send them all the most important topics for the PHC committee’s report to the MMAHB.

12.) Closing Prayer: Roseanne Sark

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PHC & PH Committee Meeting September 5, 2012 APC Office, Cole Harbor, N.S.

9:00 a.m. Opening Prayer

Welcome and Opening Remarks

Review and Approval of Agenda

Review/approval Minutes

Follow up actions/read updates

10:30 a.m. Break

10:45 a.m. HAC Evaluation update – Amanda Peters

11:30 a.m. Questions on the updates – all

12:00 p.m. Lunch

1:00 p.m. Tobacco Control Strategy

1:15 p.m. PHC/PH communication plan

2:30 p.m. Break

2:45 p.m. Input for PHC & PH subcommittee report for the next MMAHB meeting (September 19, 2012) – Co-chair, Laurie Nicholas

3:30 p.m. Closing Prayer

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Primary Health Care/Public Health Committee

September 5, 2012

APC Head Office, Dartmouth, Nova Scotia

Attendees: Laurie Nicholas, Susan Ross, Elaina Bigras, Linda MacCullum, Jackie MacDonald, Rosanne Sark, Elaine Allison, Brenda Roos, Amanda Peters, Chelsea Googoo, Janna McKay

Agenda Items Notes Actions 1. Opening Prayer / Prayer opened with Roseanne Sark Welcome and Introductions 2. Review and Agenda changed from 12-12:30 for lunch. Approval of the Agenda has been approved but with the Agenda changes by the committee. 3. Review and Minutes approved by Linda, seconded by Approval of Minutes Roseanne. 4. Review of Action #1. Not completed. Items #2. Not completed. #3. Follow up. #4. Completed. #5. Completed. #6. Completed. #7. Not completed. 5. MMAHB Amanda briefly spoke about the MMAHB update Evaluation Update – about the Health Directors document. This was Amanda Peters created by Amanda because many health directors felt they were not receiving APC health updates. Amanda presented the Draft version of the new TOR for the MMAHB and the subcommittees. She explained the new changes if approved by the MMAHB. Lots of discussion around the TOR by the committee members.

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Agenda Items Notes Actions 6. Updates from the Many committee members asked Amanda Committee and questions on the proposed TOR. She did clarify Questions much of the information. 7. Tobacco Control Heather MacDonald provided an update in hard A1: Chelsea will send Strategy copy. Louis Devon is the lead on Tobacco the speaking notes Control Strategy at the HQ office. The funding on the PP to the that will be given to the communities maybe committee members. given by clustering. A recommendation will go A2: Amanda will send to the MMAHB for a final decision. out Heather’s contact information to the committee members.

8. PH/PHC The committee discussed various ways that Communications communications could be improved under the Plan new MMAHB assuming it is approved at MMAHB:  There is a gap with AFN.  Health Canada needs to understand how the tribal organizations work and what their structure is.  There is often no one to communicate at Health Canada (while the individual is on vacation for example) then who is in the next chain of command to contact?  Recommended that we look at other T.O.’s across Canada and see how their techs work on their committees, look at the successes and the failures. Also, how can we look at traditional knowledge and incorporate it into our HAC’s and MMAHB.  Communication will work better if all committee members all trust one another.  Why are there no Heath Technician proxies if they cannot show up to a committee meeting? 9. NIHB Update – Louise had sent her update. Many of the NIHB A3: Laurie is Louise Cholock via appeals and approvals will have to be made by requesting to have telephone HQ in Ottawa. Discussion over vaccinations the roles of the dental that are not covered under NIHB. therapist and  Committee is wondering why certain consultant be ones have not been covered. I.e. TwinRx provided for the Discussion on Nurse Authorization Numbers for health techs. Louise Supplies said she will speak to  Need physician approval and Dr Jones about prescription. Nurses cannot order providing a document supplies and the communities are concerning his role at carrying the costs when supplies are FNIHB.

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Agenda Items Notes Actions needed and there is no time to wait for NIHB. A4: Elaine wants  There is a process underway that would Susan to send her allow nurses to order supplies and the information on hopefully that will be in place in the next CAET, Susan will couple months. send to the Home Care Discussion committee.  All communities will be receiving laptops for their Home Care coordinators- just working on the distribution logistics at present.

9. Input for the See A5 A5: Laurie is giving Report to the the committee MMAHB members until Sept. 12 to submit any information to be written up for the PHC & PH co-chairs report to the MMAHB. Roseanne suggested a bright spot to be sent to Laurie. 10. Closing Prayer Elaina Bigras

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Meeting Information

COMMITTEE: NIHB Committee

DATE: December 4-5, 2012

LOCATION: Office of First Nations and Inuit Health Branch, 1505 Barrington Street, Halifax 18th Floor

Agenda Items Time Item Presenter 10:00- Opening Prayer, Introductions and Ice Breaker Robin Boychuk, FNIHB 10:30 10:30- Background on MMAHB/MMAHB Evaluation Amanda Peters, APC 11:00 Process 11:00- Review of FNIHB Programs and Resources Wade Were, FNIHB 12:00 12:00-1:00 Lunch 1:00-1:30 MMAHB Cycle (Planning and Communications Amanda Peters, APC 1:30-2:30 Scope of Decision Making Wade Were, FNIHB 2:30-2:45 Break 2:45-3:15 Committee Membership, Activities, and Robin Boychuk, FNIHB Roles/Responsibilities 3:15-3:45 Meeting Processes and Administration Amanda Peters, APC 3:45-3:50 Preparing for First Nations Co-chair Selection Amanda Peters, APC 3:50-4:15 Preparation for Day 2 Activities Robin Boychuk, FNIHB 4:15-4:30 Final Thoughts and Closing DAY 2 9:00-9:15 First Nations Co-Chair Selection First Nations Committee Members 9:15-12:15 Brainstorming Activities for Workplanning Committee. Facilitated by FNIHB and APC Policy Staff

Notes on the Agenda

1. Documents that will be provided to you include:

 Slide Show from Orientation Session  Terms of Reference for MMAHB Committees  MMAHB Evaluation Report  Contact Sheet for all members of the three (3) Committee and the MMAHB  Elder Care Strategic Plan, Mental Health and Addictions Strategic Plan, Child and Youth Strategic Plan.

2. To prepare you may want to:

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 Review the Guiding Principles Document (http://www.apcfnc.ca/en/health/resources/HealthPrioritiesGuidingPrinciplesFinalVersion May2011.pdf)  Review the Terms of Reference (http://www.apcfnc.ca/en/health/mmahb.asp)  Think about items/issues that you want the committee to be working on  Please remember that First Nations and Inuit Health Branch offices are scent free and please do not bring any foods that contain onion or garlic onto the premises.  Note that lunch will not be provided, there is a food court in the building and you will be reimbursed at APC rates

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NIHB Committee Meeting FNIHB Office, Halifax December 4 and 5, 2012

Attendees: Representing: Voting members: Louise Cholock FNIHB Peter Birney UNBI Shelly McLean MCPEI Sally Johnson UNSI Laurie Nicholas MAWIW Non-voting/Observing members: Amanda Peters APC Chelsea Googoo APC Patricia Saulis APC Wade Were FNIHB Geoff Lahey FNIHB Jody Tulk FNIHB Greg Jones FNIHB Jennifer Ross-Makhan FNIHB Robyn Boychuk FNIHB Kate Gray-Mews FNIHB

Regrets: Janet Pothier and Linda Joe

Agenda Items Notes Actions Opening Prayer,  Opening Prayer: Sally Johnson Introductions and Ice  Introduction & Ice Breaker: Robyn Breaker Boychuk & Amanda Peters Background on  Amanda Peters provided a #1: Amanda will MMAHB and MMAHB background on the MMAHB send out the All Evaluation Process evaluation process and the Chiefs resolution on contents of the MMAHB the MMAHB ToR to Orientation Package. interested individuals of the NIHB committee. Review of FNIHB  Wade Were reviewed the FNIHB’s #2: Wade will send

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Agenda Items Notes Actions Programs & Services programs and services outlined in the committee an the attached MMAHB Committee up to date FNIHB Orientation: FNIHB’s role, staffing list. responsibilities, portfolios and goals. Peter Birney asked about #3: Sally suggested the role of AANDC with the adding the RHS to MMAHB, Amanda added that #3 (Measuring AANDC will be sitting at the health status – MMAHB table as an observer. identifiers, various owners of data) of “Selected Challenges we face” part of the MMAHB Orientation Package.

#4: Wade to send Laurie the 1979 Indian Health Policy online link. MMAHB Cycle  Amanda presented a detailed description on how the MMAHB cycle works, when meetings take place, and the MMAHB communications. Scope of Decision  Wade presented and explained a Making detailed process on how decisions are made between the FN parties and FNIHB. There are 3 levels of decision making: 1. Shared Decision; 2. Funding Decision (includes allocation); 3. Policy and planning Decision.  Explanation and discussion on the term co-management as different from the financial intervention definition commonly used in First Nations communities. Committee  Robyn explained the membership Membership, between the voting members and activities & the non-voting members (includes Roles/Responsibilities a representation from the Atlantic tribal organizations and the FNIHB employees). Robyn also explained how the committee activities in

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Agenda Items Notes Actions detail as well as the roles and responsibilities, the attendance of the voting members and the appointments of the co-chairs. Meeting Process and  Amanda explained the meeting Administration process and administration part behind APC (the work of the health policy analyst & the MMAHB Coordinator). The process includes: deadlines of paperwork, the logistics of the planning of meeting dates, locations, templates and any other additional work provided by APC. Preparing for First  Amanda explained the process of Nations and Co-Chair the voting of the FN co-chair. The selection selected co-chair will be chosen for the duration of 2 years. Preparation for Day 2  Both Robyn and Amanda Activities explained that a facilitator will attend day 2 of the meeting for brainstorming for the NIHB work plan. Final Thoughts and  Amanda provided a recap of the Closing days’ activities and what is expected out of day 2.

The day 2 report to be provided by facilitator at a later date.

Note: After the meeting completed FNIHB Regional Director Debra Keays-White came in to announce the staffing changes occurring at the FNIHB office. Peter MacGregor is now the acting manager of the mental wellness programs temporarily until the manager position is filled. Charmane Kay will continue to be part of the IRS program until the position is filled.

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Child and Youth Committee Meeting Crowne Plaza, Moncton, NB June 8th, 2012 9:00 am - 4:15 pm

AGENDA

8:45 am – 9:00 am Arrival and Meet and Greet

9:00am – 9:05am Welcome and Opening Prayer

Committee Co-chairs: Sally Johnson and James McGrath

9:05 am – 9:15 am Review and approval of Agenda, Minutes From Feb 2012, and Action Items - Committee Co-chairs: Sally Johnson and James McGrath

9:15 am – 10:15 am Validation of the Child and Youth Priority Setting Survey Results – Robin Boychuk, Advisor, Policy and Strategic Planning, FNIHB and Amanda Peters, Senior Health Policy Analyst, APC

10:15 am – 10:30 am Nutrition & Stretch Break

10:30 am – 11:30 am Discussion and Input From the Committee on the Core Elements and Outline for the Child and Youth Strategic Action Plan - Robin Boychuk, Advisor, Policy and Strategic Planning, FNIHB and Amanda Peters, Senior Health Policy Analyst, APC

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11:30 am – 12:15 pm Next Steps For The Process in Developing the Child and Youth Strategic Action Plan - Robin Boychuk, Advisor, Policy and Strategic Planning, FNIHB and Amanda Peters, Senior Health Policy Analyst, APC

12:15 pm – 1:00 pm Lunch Provided

1:00 pm – 2:30 pm FASD Program Funding 2013-2015 – Barbara Broom, Clinical Nurse Specialist, FNIHB

2:30 pm – 2:45 pm Nutrition & Stretch Break

2:45 pm – 2:55 pm General Update on MMAHB Activities - Amanda Peters, Senior Health Policy Analyst, APC

2:55 pm – 3:15 pm Regional Employment, Education and Early Childhood Survey – Sally Johnson, Health Technician, UNSI

3:15 pm – 4:00 pm First Nation Organization and FNIHB Child and Youth Program Updates** (All) (About 5 mins/report) ** In your updates, it would be helpful if you could include the following 2 sections – (1) Upcoming C and Y Training / Education / Workshops including dates that your organization/program may be hosting before March 31, 2013 (2) Highlight any potential items that should be included in the MMAHB update (i.e. C & Y subcommittee items that need MMAHB support)

4:00 pm – 4:10 pm Review of Meeting Action Items From Recorded Minutes – Chelsea Googoo-Brown, MMAHB Coordinator, APC

4:10 pm – 4:15 pm Closing Remarks - Committee Co-chairs: Sally Johnson and James McGrath

4:15 pm Closing Prayer

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Child & Youth Committee Meeting June 8, 2012 Crowne Plaza

Attendees:

Philippa Pictou, CMM James McGrath, FNIHB; Co-Chair Margie Fowler, FNIHB Sandra Musgrave, FNIHB Sally Johnson, UNSI; Co-Chair Andrealisa Belzer, FNIHB Tammy Arsenault, MCPEI Amanda Peters, APC Caryn Small Legs-Nagge, FNIHB Cheyenne Mary, FNIHB Robin Boychuck, FNIHB Barbara Broom, FNIHB Pam Gough, FNIHB Chelsea Googoo, APC

1.) Arrival and Meet & Greet: Co-chair James McGrath

2.) Welcome and Opening Prayer: Sally Johnson

3.) Review and approval of Agenda, Minutes from Feb. 2012, and Action Items:

- Review and Approval of agenda: agenda approved by the committee.

- Review of Minutes: approved by the committee.

- Review of Action Items:

Action Item #1: Chelsea will resend all 4 sets of C&Y minutes to all the committee members (completed).

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Action Item #2: Glenda will research into the number of FN women breast feeding, including the breakdown of the numbers per province and come back to the committee and/or co-chairs. (Deferred until the next meeting, Andrealisa will follow up)

Action Item #3: Barbara will send an electronic copy of the document to each FASD/health community worker and to the C&Y committee members. (Completed: was sent to the health community workers; not FASD workers)

4.) Validation of the C&Y Priority Setting Survey Results: Amanda Peters & Robin Boychuck:

- Discussion and Input from the Committee on the Core Elements and Outline for the Child and Youth Strategic Action Plan

- Next steps for the Process in Developing the Child and Youth Strategic Action Plan

Robin asked for the committee to review the documents and give them 2 weeks instead of reviewing during the morning only.

Action Item #1: C&Y committee members to contact Amanda/Robin about their thoughts, feedback and ideas on the results of the survey within 2 weeks from today, June 22, 2012. Robin will send a follow up email as a reminder.

List of ideas from the results of the survey:

- Better to list the top 5, rather than the other priorities as lower priorities.

Laurie asked about the age of youth, who are the youth and what age range? Amanda said MMAYC considers youth to be up to 25 years old. This committee will recognize MMAYC’s age limit of 25 years old.

The MMAHB might meet the week of September 18-20, which is a week before All Chiefs.

Laurie suggested for the community members to be provided with an executive summary.

Culture and language seems to be one of the most important priorities among the results as it continues to show up every time.

5.) FASD Program Funding 2013-2015 (Barbara Broom, Clinical Nurse Specialist, FNIHB:

- Note: Barbara provided 4 documents on the FASD funding.

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- Note: Caryn & Cheyenne: explained in detail about the FASD Program population based funding distribution, (chart) regarding the FASD funding. The First Nations members reviewed the 3 different options and voted, listed below are the results of the vote:

- Laurie Nicholas: status quo - Amanda Peters: status quo - Tammy Arsenault: status quo - Marie Levi: RFP (met with the Assembly of NB Chiefs on May 17, majority voted for RFP). - Sally Johnson: status quo - Phillipa Pictou: status quo

Status quo is option #1: fund the 8 existing projects for two more years 2013-2015 and then revisit this discussion (From FASD Funding letter from Barbara Broom).

Majority of the Tribal Organizations (T.O.’s) representatives agreed with option #1 (status quo). However this committee will revisit the decision again.

Action item #2: The FASD funding vote from the T.O.’s members will be brought to the June 19 MMAHB meeting and the co-chairs will report the recommendation.

James asked about the decision of the T.O.’s: if this recommendation goes forward, what do we say or what happens next? Barb suggested we say this is a consensus vote…also looking at 2015 to better understand the funding protocol and exploring the options for the next 2 years.

Action Item #3: Sally and Amanda to write up the FASD funding/vote recommendation to the MMAHB.

6.) General Update on MMAHB activities, Amanda Peters:

- Funding Cuts from the Atlantic (Valerie Gideon at All Chiefs):

- $735,000 cuts in the Atlantic.

- 3% growth will continue in the communities.

- UNBI, CMM, APC, received cuts in the policy and consultation areas.

- HSIF no FN input for HSIF, however Kate Gray Meuse is working on it.

- Health Careers were entirely cut nationally.

7.) Regional Employment, Education and Early Childhood Survey – Sall Johnson, Health Technician, UNSI:

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This position will be responsible for NS, PEI and NFLD. Sally is in the process of hiring a REES Coordinator and a Statistical Data Analyst. FNIGC is funding these 2 positions through UNSI.

Action Item #4: Sally will email Chelsea the REES Coordinator and the Statistical Data (2 UNSI job opportunities) to forward to the C&Y members to share.

8.) First Nation Organizations and FNIHB Child & Youth Program Updates:

Sally Johnson, FNIHB: Sally will be attending the AFN’s national health technicians for 3 days next week in Ottawa, Ont. She also gave an update on the REES Coordinator position from UNSI.

Pam Gough, FNIHB: Pam provided an update on hard copy. Her update includes community dental visits.

Barbara Broom, FNIHB: Barbara provided an FASD and Injury prevention update. The PARTY (is a program) is to get more facilitators to train more trainers to be added to this program for every grade 9 students to raise awareness.

Philippa Pictou, CMM: Jordan’s Principle update: court case is Monday and Tuesday in Halifax. There will be a walk starting at the Friendship Center to the Courthouse starting at 12:00pm on Monday. The Social update with the Tripartite level, new funding for a person to look at the services on and off reserve. This is for mapping a program with the Social Tripartite Coordinator.

Pictou Landing recently set up a new committee for more awareness on Bathsalts. They also had a drug information session as well as an emergency meeting. Both Pictou Landing and Paqtn’kek now share a FN Nurse Practioner funded by the DHA of New Glasgow.

Amanda Peters, APC: Amanda read aloud the All Chiefs who just passed a resolution yesterday (June 7), along with All Chiefs across Canada on the welfare of children and youth, it is being passed nationally with all the First Nations Chiefs.

The All Chiefs also passed the MMAYC Conference resolution for each community to pitch in $1200.00 for 2 youth and 1 IRS Survivor to attend the conference in Fredericton, NB at UNB. The conference dates are August 6-8, 2012.

Action #5: Amanda said she will send the All Chiefs Resolution for the welfare of FN children and youth, which is still in draft format, once its’ completed and will forward it to the C&Y.

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Tammy Arsenault, MCPEI: Lennox Island is trying to set up a Radio station for the youth. The boys and girls club will be having a golf tournament this summer on July 16, and invited Theo Fleury (former NHL player who is Metis).

Action Item #6: James asked for all the members to send/email their member update to Chelsea to add into the master copy and to have an electronic copy.

James McGrath, FNIHB: James submitted an update. (James can you fill in this area regarding your update)

Action Item #7: Barbara invited Philippa to the FN C&Y: MHA meeting on July 10 at the IWK to make a presentation on the recent Bathsalts issue that had occurred in Pictou Landing.

9.) Review of Meeting Action Items from recorded minutes – Chelsea Googoo:

Chelsea read aloud the 7 action items recorded.

10.) Closing Remarks: Co-Chair Sally Johnson

11.) Closing Prayer: Sally Johnson

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Child and Youth Committee Meeting APC Office, Cole Harbour, NS September 7th, 2012 9:00 am - 4:00 pm

DRAFT AGENDA

8:45 am – 9:00 am Arrival - Meet and Greet

9:00 am – 9:10 am Welcome and Opening Prayer Committee Co-chairs: Sally Johnson and James McGrath

9:10 am – 9:20 am Review and approval of Agenda, Minutes From June 2012, and Action Items - Committee Co-chairs: Sally Johnson and James McGrath

9:20 am – 10:10 am MMHAB Evaluation Results and Proposed MMHAB Terms of Reference – Amanda Peters, Senior Health Policy Analyst, APC

10:10 am – 10:40 am First Nations Tobacco Control Strategy - Amanda Peters, Senior Health Policy Analyst, APC and/or Brenda Roos, Regional Nurse Manager/ADI Program Manager, FNIHB

10:40 am – 11:00 am Nutrition & Stretch Break

11:00 am – 12:15 am MMAHB Child and Youth Strategic Action Plan - Robin Boychuk, Advisor, Policy and Strategic Planning, FNIHB and Amanda Peters, Senior Health Policy Analyst, APC

12:15 pm – 1:15 pm Lunch Provided

1:15 pm – 1:25 pm Introduction of FASD/IP Nurse Coordinator – Tracy Lovett, Nurse Coordinator – FASD/IP, FNIHB

1:25 pm – 2:10 pm Overview of the Children’s Oral Health Initiative (COHI) – Pam Gough, COHI Coordinator, FNIHB

2:10 pm – 2:30 pm Roundtable First Nation Organization and FNIHB Child and Youth Program Updates** (All)

2:30 pm – 2:50 pm Nutrition & Stretch Break

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2:50 pm – 3:50 pm Roundtable First Nation Organization and FNIHB Child and Youth Program Updates** (All)

** In your updates, it would be helpful if you could include the following – (1) Upcoming C and Y Training / Education / Workshops including dates that your organization/program may be hosting before March 31, 2013 (2) Highlight any potential items that should be included in the MMAHB update (i.e. C & Y subcommittee items that need MMAHB support)

3:50 pm – 3:55 pm Review of Meeting Action Items From Recorded Minutes – Chelsea Googoo-Brown, MMAHB Coordinator, APC

3:55 pm – 4:00 pm Closing Remarks - Committee Co-chairs: Sally Johnson and James McGrath

4:00 pm Closing Prayer

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Child and Youth Committee

September 7, 2012

APC Head Office, Dartmouth, Nova Scotia

Attendees: Sally Johnson, James McGrath, Barbara Broom, Cheryl Chisholm (for Margie Fowler), Leanne Yates (For Andrealisa Belzer), Robyn Boychuk, Tammy Arsenault, Pam Gough, Small Legs-Nagge, Philippa Pictou, John Sylliboy, Marie Levi may call in, Laurie Nicholas

Agenda Items Notes Actions 1. Opening Prayer  Sally provided opening prayer and / Welcome and welcoming remarks Introductions 2. Review and  Wade will present at 1:25 and Pam at A1: Caryn and James Approval of the 9:20 will send the updates to Agenda and  Agenda will be as is include in the notes Minutes  Lunch is shortened for 30 min.  Meeting minutes: #8 Caryn Small Legges provided updates as did James which need to be included  Question on Action #2 – If this action is to be deferred to this meeting? Answer- it was already done. Glenda would (pg.2)  2nd paragraph under Philippa – clarification will be provided by Philippa  Clarification also that it is not a nurse practioner, but a mental health practioner (also will be clarified by Philippa)  Sally suggested to review all action items:  Chelsea’s action is completed  # 2 is done  #3 is completed  #1 for pg. 2, completed – revise typo on

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Agenda Items Notes Actions by instead of from 22nd.  Recommendations action completed and accepted  #4 is done  #5 Amanda is not here to see if it is done….Sally does not recall and it was then deferred to the next meeting  #6 James followed up, but Chelsea needs to answer this…deferred  #7 is done. FN Health – add “network” from Barbara  Sally suggested that there be a video to show for the next C&Y meeting – Philippa provided information on an APTN interview and DVD will also be provided – which can be shared later  Minor revisions needed but meeting minutes are accepted 3. MMAHB Wade Were is presenting on Amanda’s Evaluation Update behalf – A. Peters Reviewed the ToRs for the MMAHB and the committees that will be going to the MMAHB for approval later in the month. Some general discussion on how it will be organized; how will the Child and Youth issues be properly addressed under the new structure? etc. 4. Federal First Brenda Roos presented on the Federal Nations Tobacco Tobacco Strategy for information purposes Strategy – B.Roos only. Some of the topics reviewed included:  500-600K per region per year (25M for the next five years for national)  There was a stakeholder meeting last week Aug. 27 hosted by APC. Recommendations were sought for MMAHB to best roll out the initiative. Two options are going forward to MMAHB, which then will be presented to All Chiefs the following week.  The Strategy has been quite “prescriptive” from HQ in relation to essential criteria lead by HQ, like call for proposals or any roll out. There has to be methods for data collection and evaluation for progress and results. 5. Child and Youth Robyn gave an overview of the Strategy, survey, A2: Amanda to Strategic Plan – A. expectations and general direction for forward the Peters and R. leadership, stakeholders and future next steps document to folks on

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Agenda Items Notes Actions Boychuk Input is required and sought for some areas at this committee (MOU this table, especially for areas of who should with CRC) lead in what area: policy etc. Robyn revewied the discussion questions

 How will it be ensured that this strategic plan will be a priority in the next committee? Robyn suggested to bring it up in the afternoon with Wade’s presentation - how does this committee envision to bringing this to another committee? Please bring it up this afternoon with Wade.  Robyn/Sally: the Canadian Red Cross – AFN and there is a MOU in place that can be a spring board to other areas for service. There should be a reinforcement of support for this type of agreement. A3: Robyn will add More regional orgs and tribal orgs could clarification of the follow this model for such programs as score card process. injury prevention. This could also be used for community health planning  Implementation: HC shares the concerns for the implementation of measures for the plan and its usage….what are the first few steps of implementation? A formal endorsement is required at the Chiefs level.  Measuring and reporting: is there a possibility for an annual evaluative? There is a score card that is included in the implementation as well. It will be integrated to the existing reporting requirements and processes. Will there be a specific reporting for this. Yes, there will be, but also in coordination with existing reporting methodologies. Robyn: What is realistic that could be included in the score card that will be identified in the logic model…  Does it outline the existing process in place, such as Micmac family services? Will they be informed that this strategy exists? Will there be some sort of communication to inform other programs that are ongoing for child and youth programs? There will be community staff A4: Robyn will clarify that would need to be informed on the what the culture and strategy as part of the implementation language piece what

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Agenda Items Notes Actions process the youth had refereed  What do you mean by technology? to. Robyn explained that there are various models to contextualizing the outcomes through models like the medicine wheel, or other visual representation. The idea is that this table helps to give input.  Would this be included in the following MMAHB for endorsement? And what are the following activities for the following years aside from year one? This would have to happen via consensus with First Nations and from HC. Year one activities could be revisited so that there is some implementation of initial activities to start up. Perhaps, priorities could be better identified as next steps. Robyn assured that there would be clarification on short and long term outcomes in the footnotes.  There will also be a realistic and doable evaluation plan keeping in mind that it would not add on to existing workloads.  Laurie: the report needs to be reworded on page 7 for culture and language. The recommendation is to revisit that area that clarifies the what the youth referred to with respect to language and culture  Clarify that the reference for Atlantic refers to the FNs, but not necessarily representative of all, such as the Innu.  The development process should be included and better detailed in the document – companion documents and background information.  Suggestion is to look at the formatting so that it would be more read friendly and some other visual formatting for graphs.  Robyn can take written submission right up to Sept. 11 regarding the document.  Vague activities: Get rid of “endorse”; Question #7 – share it now, not wait. 6. FASD/IP Nurse  Committee was introduced to the new Coordinator FASD/IP Coordinator at FNIHB  Committee did introductions as well

7. Overview of The Children’s Oral Health Initiative (COHI) COHI – P. Gough falls under the MCH (Maternal Child Health ) program. Overview of the program was provided by Pam Gough. Some of the issues

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Agenda Items Notes Actions discussed were:  There are 40 currently working under various programs – like MCH workers  There should be a master list of the who is doing what in the services for COHI.  What’s the plan for funding in the future? Will this sunset? There has not be a date established, but it seems there will be a program evaluation in November.  What will the services look like when schools closed? There is a shift of services from Dental therapists to Dental hygienists (DTs operate only in two provinces – Manitoba and Sask) DTs can only work on communities but should be working in more communities  Vancouver college is looking into expanding dental hygienists responsibilities. Hygienists are self- regulated in most provinces 9. Committee Sally Member Updates  FNIGC meeting is next week where they will be discussing the REES Survey (Regional Education, Employment and Early Childhood Development Survey)  How many communities are on the RHS? 13 in NS, 2 in PEI, Tobique in NB, and Conne River for NL. UNBI does the NB, but only completed 6 communities, which was also to include PEI. There is a high 90+% response rate in NS. There have been problems here and there. Once the reporting is done, findings and concerns will be shared.  AFN National Health Technicians Meeting in Ottawa – Sally will send the agenda for people review and make suggestions for discussion topics.  John asked Sally if the Wabanaki Two Spirit Alliance could attend a meeting to help capture data respecting two-spirit information. MCHP:

 Curriculum dates for November and December  Video on education sessions for the next round are: (refer to her document)  Cheyanne is still doing the circles

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Agenda Items Notes Actions  NB screening tool – for community health nurses, are they recommended to use the same resources/guides?  What percentage of the program have home visitors? Most of the communities have a home visitor

COHI:  Training session to be delivered at the end of the month  Indian island and Buctouche will be delivered  NS will be for quality assurance starting in CB in October  PEI for Abegweit  Fluoride washes…none of the A5: Leanne to forward communities were not reaching the goal. the BC Schedule to The goal will be now 2 fluoride distribute to the applications. committee and also the dates of the next  Do those 2 applications are the minimal committee meetings. requirement. Pam says it is the scientific requirement Tammi:  MCH database will be applied on for Lennox Island  Is it similar to the Manitoba database. It is similar but had been adapted to their needs. Health Information Analysis Solutions – Ehealth Solutions

 Refer to the document that Leanne provided  There are communities that will be evaluated in the region

 If there is anyone that is interested in a session, then please forward the information and request to Leanne? James asked on the dates – which will be ongoing until December.  When are the next HIA committee A6: Barb/Tracey to meetings? ask questions in Cheryl reference to screening and other  Health planning take part in NL right now related topics for  Sandra is working on the nursing policies communities and guidelines provide an update  Two other communities would like to later. work with the nursing policies as well

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Agenda Items Notes Actions  Planning committee with Atlantic First Nations Health Nursing Conference on Oct. 2-4  CDC perspective – NB invited the communities and Lynn was there  Protesis was discussed and that NB is promoting immunization  FYI – immunization for FN children are usually well immunized, however, children between 0-4 years of age need to be looked at Clinical Nurse (Barb)

 THIF projects and one with Miramachi will be working together with Burnt Church  Sept. 18 will be meeting in Eel Ground, Tracy will be the contact for FASD  Building Brighter Kids  Co-Chair with Amanda P for a meeting that was attended at the IWK for the mental health and addictions committee

 Cheryl: has there been outreach for the

alcohol strategy with FN communities?

Barb has only heard it at one place, but

clarified that university students are the

main target

 The NASPS position has been posted

James:

 Provided a report that could be referred

to. A7: John will touch  What are conversational maps? They are base with Marie to maps as visual tools to discuss with discuss any potential diabetes patients about their diabetes programs for AHHRI and medication. and NBCC and  They are tools that could be used for the Miramachi patients. There is a 30 min slot for the nursing conference. Tammi mentioned that Lennox have had a provincial person that had trained someone in that community.

Philippa:

 From Gillian at CMM – the province has offered training for screening for hearing and speech

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Agenda Items Notes Actions  A proposal has been submitted to FNIHB to cover the costs  The Jordan’s Principal is awaiting the final decision – seemed positive  Adele has been hired to map out what the services are available in communities and the province  Pictou folks were interviewed and the interview will be aired on Sept. 7 on APTN  Gillian can address the questions that Barb and other have stated  Children are not getting screened at the community level… Aboriginal Head Start

 Literacy night in FF and Buctouche  Phonics in Elsipogtog and ?  NBCC in development of special projects  Active Kids on the provincial committee and putting together a special kits training  Updates on the website  Train the Trainer in phonics  Training set for ECE at the Rodd Miramachi for the NB headstarts  Building Blocks training…  Orientation for the ECE training – got 5 but need 3 more students  On line courses  Orientation manual for the EC program that is being completed

10. Review of Refer to Topic #2 Action Items 11. Closing Prayer  Closing remarks….just wait and see what will happen when the MMAHB moves forward  Closing prayer

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Meeting Information

COMMITTEE: Public Health and Primary Care Committee

DATE: December 11-12, 2012

LOCATION: Holiday Inn Harbourview, Dartmouth Nova Scotia

Agenda Items Time Item Presenter 10:00- Opening Prayer, Introductions and Ice Breaker Robin Boychuk, FNIHB 10:30 10:30- Background on MMAHB/MMAHB Evaluation Amanda Peters, APC 11:00 Process 11:00- Review of FNIHB Programs and Resources Wade Were, FNIHB 12:00 12:00-1:00 Lunch 1:00-1:30 MMAHB Cycle (Planning and Communications Amanda Peters, APC 1:30-2:30 Scope of Decision Making Wade Were, FNIHB 2:30-2:45 Break 2:45-3:15 Committee Membership, Activities, and Robin Boychuk, FNIHB Roles/Responsibilities 3:15-3:45 Meeting Processes and Administration Amanda Peters, APC 3:45-3:50 Preparing for First Nations Co-chair Selection Amanda Peters, APC 3:50-4:15 Preparation for Day 2 Activities Robin Boychuk, FNIHB 4:15-4:30 Final Thoughts and Closing DAY 2 9:00-9:15 First Nations Co-Chair Selection First Nations Committee Members 9:15-12:15 Brainstorming Activities for Workplanning Committee. Facilitated by Consultant 12:15-1:00 Lunch 1:00-3:00 Brainstorming Activities for Workplanning Committee. Facilitated by Consultant

Notes on the Agenda

1. Documents that will be provided to you include:

 Slide Show from Orientation Session  Terms of Reference for MMAHB Committees  MMAHB Evaluation Report  Contact Sheet for all members of the three (3) Committee and the MMAHB  Elder Care Strategic Plan, Mental Health and Addictions Strategic Plan, Child and Youth Strategic Plan.

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2. To prepare you may want to:

 Review the Guiding Principles Document (http://www.apcfnc.ca/en/health/resources/HealthPrioritiesGuidingPrinciplesFinalVersion May2011.pdf)  Review the Terms of Reference (http://www.apcfnc.ca/en/health/mmahb.asp)  Think about items/issues that you want the committee to be working on  Note that lunch will be provided

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Public Health & Primary Care Committee Meeting Holiday Inn Harborview December 11 and 12, 2012

Attendees: Representing: Voting members: Dan MacDonald Miawpukek Leila Gillis FNIHB Roseanne Sark MCPEI Beverley Madill UNSI Laurie Nicholas MAWIW Elaina Bigras UNBI Janna MacKay CMM Non-voting/Observing members: Amanda Peters APC Chelsea Googoo APC Linda McCallum FNIHB Wade Were FNIHB Len O’Neill FNIHB Brenda Roos FNIHB Agatha Hopkins FNIHB Robyn Boychuk FNIHB

Regrets: Sandra Musgrave

Note: Before the meeting officially started FNIHB Regional Director Debra Keays-White came in to announce the staffing changes occurring at the FNIHB office. Peter MacGregor is now the acting manager of the mental wellness programs temporarily until the manager position is filled. Charmane Kay will continue to be part of the IRS program until the position is filled.

Agenda Items Notes Actions Opening Prayer,  Opening Prayer: Roseanne Sark Introductions and Ice  Introduction & Ice Breaker: Breaker Amanda Peters Background on  Amanda Peters provided a MMAHB and MMAHB background on the MMAHB

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Agenda Items Notes Actions Evaluation Process evaluation process and the contents of the MMAHB Orientation Package. Review of FNIHB  Wade Were reviewed the FNIHB’s Programs & Services programs and services outlined in the attached MMAHB Committee Orientation: FNIHB’s role, responsibilities, portfolios and goals. MMAHB Cycle  Amanda presented a detailed #1: Chelsea will description on how the MMAHB send the calendar cycle works, when meetings take invite to every place, and the MMAHB MMAHB and communications. committee meeting for 2013. #2: Chelsea will add the MMAHB Chief co-chairs to the MMAHB non-voting section of the membership list. Scope of Decision  Wade presented and explained a Making detailed process on how decisions are made between the FN parties and FNIHB. There are 3 levels of decision making: 1. Shared Decision; 2. Funding Decision (includes allocation); 3. Policy and planning Decision. Both Elaina and Roseanne would like First Nations to be included in the FNIHB work plans, Leila agreed another lens would benefit. Most FNIHB work plans are due in February each year then rolled out April1st. Committee  Robyn explained the membership Membership, of the voting members (includes a activities & representation from the 6 Atlantic Roles/Responsibilities tribal organizations and 1 FNIHB employee). The non-voting members would be APC and FNIHB staff. Robyn also explained how the committee activities in detail as well as the

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Agenda Items Notes Actions roles and responsibilities, the attendance of the voting members and the appointments of the co- chairs. Meeting Process and  Amanda explained the meeting Administration process and administration part behind APC (the work of the health policy analyst & the MMAHB Coordinator). The process includes: deadlines of paperwork, the logistics and the planning of meeting dates, locations, templates and any other additional work provided by APC.  Note: during discussion, a gap was identified: how will the AFN information come to the committee table, since the National Health Techs Sally & Peter do not sit on all 3 of the committees. Preparing for First  Amanda explained the process of Nations and Co-Chair the voting of the FN co-chair. The selection selected co-chair will be chosen for the duration of 2 years. Preparation for Day 2  Both Robyn and Amanda Activities explained that a facilitator will attend day 2 of the meeting for brainstorming for the PHPC work plan. Final Thoughts and  Amanda provided a recap of the Closing days’ activities and what is expected out of day 2.

The day 2 report to be provided by facilitator at a later date.

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Wellness Committee Meeting May 23, 2012 The CMM Board Room, Millbrook First Nation

9:00 a.m. Opening Prayer Welcome and Opening Remarks Review and Approval Agenda and minutes Follow up actions, Updates (all)

1030 am Break

10:45 Wellness Workplan

11:30 FNIHB Co-Chair nomination and appointment

1:00 pm Updates - all

2:00 pm HAC evaluation update- Amanda Peters

2:45 pm Input for Wellness Subcommittee Report for next MMAHB meeting (June 19/12

3:15 pm Closing Prayer

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Wellness Meeting CMM Office, Millbrook, N.S May 23, 2012

Attendees: Loraine Etter, APC Josephine Muxlow, FNIHB Amanda Peters, APC Barbara Broom, FNIHB Sally Johnson, UNSI Lita Richardson, MAWIW Gerard Gould, MCPEI Janet Pothier, CMM, Wellness Co-Chair Jennifer Gagnon, Observer Peter Birney, UNBI Chelsea Googoo, APC

Regrets: Laurie Nicholas, Val Polchies, Gena Gallant

1.) Opening Prayer: Sally Johnson

2.) Welcome and Opening Remarks: Co-Chair Janet Pothier

3.) Review and approval of agenda and minutes:

- Added to the agenda: bath salts issue. - FNIHB Co-chair nomination will be deferred until the next meeting. - Wellness Work plan: deferred to the next meeting, including the membership of the committee list; instead a discussion on info about national updates. - REES: Sally wants to add to the agenda (after lunch). - Amanda: wants the child & youth strategic directions added.

Note: No changes to the minutes to the September 7&8th meeting. Minutes are approved.

Review of September, 2011 Action Items:

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#1: completed. #2: completed. #3: completed. #4: not completed. #5: completed. #6: Loraine will send out instead. #7: no updates have been sent. #8: it was taken to the MMAHB; no decision has been made. #9: feedback given; completed. #10: not completed; not done; however they will start. #11: completed; Janet will follow up. #12: completed; Janet will photocopy to pass out to the committee members; Sally will forward the document to the wellness committee members. #13: completed. #14: not completed; follow up with Laurie. #15: completed. #16: completed. #17: not completed.

Review of November 30 TRI-HAC action items:

#1: no changes; overturned. #2: Amanda will send; Chelsea did not.

Note: Minutes have been approved by the committee with the changes completed electronically and immediately by Chelsea Googoo.

4.) HAC Evaluation Update: Amanda Peter:

Amanda provided Lita Richardson a brief history on the MMAHB and its’ subcommittees. Valerie Gideon will speak about the MMAHB evaluation at the All Chiefs and give an update/status. It has been put on hold since the fall of 2011.

Many people at the table are very discouraged about the federal cutbacks on the First Nations Tribal organizations, especially in the health departments.

Janet: FN people are heavily being impacted on the federal cutbacks. It seems like the only way to resolve many issues is through legal means and we need collective action from the Chiefs in an attempt to halt further cuts since it seems the federal government doesn’t consider FN health a priority.

Peter added that as we, the FN, have been cut dramatically and been trumped by bilingualism from the government and it is viewed as a higher priority rather than First Nations’ Aboriginal and Treaty Rights. There was no consultation from the federal level to the Tribal organization level about the cutbacks.

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AFN Health technicians meeting in June will be held for 3 days in Ottawa. The AFN AGA takes place in July, 2012 and the federal cutbacks will be the dominant theme especially in health.

Action Item #1: Sally will send the committee the agenda and is asking for recommendations to be added to the AFN Health Technicians agenda for the June meeting.

5.) Wellness Work Plan:

Peter: to be added: - NIHB Resolutions/Key activities section: Opioid Addiction/methadone clinics. - Medical transportation.

Josephine: the brighter futures and building healthy communities section; should be added to this years’ work plan.

Action Item #2: Janet wants to have a strategically written work plan in order to share with our communities.

Gerard: communication is still not going through from the feds to the grassroots. Is there anything being done to have better communication to the communities?

6.) FNIHB Co-Chair nomination and appointment:

This item has been deferred until the next wellness committee meeting.

7.) Updates – All:

Loraine Etter, APC: Loraine’s update is provided on hard copy.

Peter Birney, UNBI: Peter’s update is provided on hard copy.

Janet Pothier, CMM: Janet’s update is provided on hard copy.

Action Item #3: Janet will send Chelsea the Summit on Mental Health document to email the committee members.

Lita Richardson, MAWIW rep; Burnt Church Health Director: Medical transportation received cutbacks for the methadone patients; however 2 nurses and a pharmacist will now be in Burnt Church; Loraine said a van may be available from FNIHB to the methadone clients during the work week.

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Sally Johnson, UNSI: Sally’s update is provided on hard copy. AFN’s committees will be restructured due to the loss of AFN staff because of the federal cutbacks. RHS Survey will include: NS, PEI and NFLD. Deadline is May 30 for the complete survey report, both Fred Wien and Mindy Denny will report. UNSI have not received federal health cutbacks to date.

Barbara Broom, FNIHB: Barbara’s update is provided on hard copy.

Action Item #4: Chelsea will send FNIHB’s Video Conferencing education sessions spring session for 2012.

Josephine Muxlow, FNIHB: Josephine’s update is provided on hard copy.

There was some discussion around the Bath Salts issue at the table, many technicians are very worried about this new drug and the impacts of Bath Salts will have in the communities.

Amanda Peters, Report and Recommendations of the Mental Health and Addictions Strategy Advisory Committee Addressing First Nations Concerns in N.S.: Amanda provided a hard copy.

Action Item #5: Amanda will send/email Peter Birney a copy of the above mentioned report.

8.) Input for Wellness subcommittee report for the MMAHB:

- Update on the bath salts, it needs to be discussed as an emerging issue. - Possibility: invite someone from Pictou Landing to update the committee on the collaborative work done to address the issues of Bath Salts in Pictou County. - Recommend: action/address the federal cutbacks. - IRS funding.

Follow up meeting with a teleconference meeting date: Tuesday, June 26, 2012 at 10:00 am to 11:30 am for reviewing the action items, the minutes, the new agenda and new meeting date.

Action Item #6: Chelsea will send a calendar invite for the wellness teleconference meeting. (completed May 24).

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Wellness Committee Meeting September 6, 2012 The APC Board Room, Cole Harbour NS

9:00 a.m. Opening Prayer

Welcome and Opening Remarks

Review and Approval Agenda and minutes

9:30-10:30 Committee member Updates (highlights)

1030 am Break

10:45 MMAHB Evaluation

11:00 Federal First Nations Tobacco Strategy

11:30 Addictions meeting MMAHB September 20

12:00 pm Lunch

1:00 pm DUPP Funding/Presentation

2:00 pm NAYSPS Coordinator Networking Session - Eval

2:30 pm Break

2:45 pm Federal Co-chair nominations and replacement (discussion)

3:00 pm Input for Wellness Subcommittee Report for next MMAHB meeting (September 19 & 20, 20102)

3:15 pm Closing Prayer

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Wellness Committee

September 6, 2012

APC Head Office, Dartmouth, Nova Scotia

Attendees: Sally Johnson, Barbara Broom, Janet Pothier, Gena Gallant, Peter Birney, Joseph Denny, Cindy Ginnish, Tracy Lovett, Laurie Nicholas, Christiane Poulin, Josephine Muxlow, Amanda Peters

Agenda Items Notes Actions 1. Opening Prayer / Opening Prayer – Sally Johnson Welcome and Co-Chair: Janet Pothier Welcome and Introductions Introductions 2. Review and There is a DUPP Evaluation available online. A1: Sally will send Approval of the Maybe we should look at it. Will look for the the National health Agenda and Minutes Evaluation for lunch. Agenda Accepted by Techs agenda to the consensus group for comments and Minutes: Pasted with the following changes. recommendations for  Cindy Ginnish sent her regrets for the the September 2012 May 23 meeting. meeting  Page 3 change the language to Language Rights from Aboriginal Treaty A2: June 26, 2012 Rights. Wellness Action Items: teleconference  A1: Completed. Notes: Chelsea to  A2: Will be worked on the autumn. send out to the  A3: Completed Committee.  A4: Completed  A5: Completed A3: Chelsea to ensure that email list  A6: Completed for the Wellness Committee is updated. 3. Committee Member Cindy Ginnish: A4: Cindy to forward Updates  Reviewing the presentation provided in the FN Mental

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Agenda Items Notes Actions the package re: Regional Presentation Wellness Continuum on Key Renewal Achievement and Framework to the Plans to Date. Wellness Committee  Cindy will be leaving Native National – Completed at the Addictions Partnership Foundation meeting (NNAPF), will no longer national representative  Wellness Committee could work to move renewal activities forward in the work plan.  Maliseet Mental Wellness Team did not understand how to connect to the NNADAP workers and treatment centres at a meeting in July. Discussion on how to make those connections and helping people to understand the A5: Joe and Janet to processes for treatment centres and speak about the Give how to access them. Us Wings Project Joe Denny: and NADACA having  Reviewed the programs under a position on the NADACA in Nova Scotia i.e. Steering Committee Prescription Drug and Opioid Programs, Relapse Program etc. Christiane Poulin:  Staffing issues at FNIHB reviewed. Valentino Polches and Patrick Small Legs-Nagge are both gone. Those positions are open but subject to Work A6: Discussion on Force Adjustment within the federal having Barb Martin government. IRS position is currently come present to the open as well. Wellness Committee Laurie Nicholas:  Reviewing her experience with and invited Elder to some NB communities to talk about wellness. For more information: www.turtlelodge.org  Mi’kmaq Maliseet Healing Network: funding ending soon, June 2012. Need to find a way to sustain it.  Reclaiming Our Ancestral Footsteps pilot project has ended. Reviewing evaluation at present. Will be presenting at the Health conference in November. Thinking about next steps. Janet Pothier:  The HSIF Provincial Project on MHA has been funded, Focus of the project to develop relationships to have services offered at the community level.

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Agenda Items Notes Actions All NS communities are involved. Steering Committee will be meeting and Coordinator to be hired  NNAYPS Networking Session, November 13-14 for the 11 projects.  Provincial Tripartite Disabilities Project working with provincial groups and communities looking at services available or not available in FN communities. (both provincial and federal services) Will be working on an Action Plan to address identified gaps.  Cultural Safety Modules for training health staff at the province continues through the Give US Wings Project. Barbara Broom:  Working with NB Mental Health Project in Miramichi with the 3 communities.  Working with the 3 Mental Wellness Teams. Maliseet Team very busy  Work with Family Health Programs as well.  Sits on National NNAYPS, BHC/BF Committees and would like to attend NNAYPS Networking Session Peter Birney:  No update per se: Dealing with Budget cuts at UNBI  UNBI continuing the NNAYPS program. Currently collecting community work plans  HSIF meeting Monday, two new projects for consideration from the RHAs about cultural education. They look promising. Sally Johnson:  Meeting with FNGC in Yellowknife this month. Has concerns and questions regarding the REES for discussion. REES Coordinator is Mindy Denny and Statistical Analyst Gerald Gloud. REES will not cover all communities. Survey should be out in the new fiscal year at latest.  RHS Report is due this month. The Advisory Group and MHRG will be meeting September 28, 2012 to review report.  National Health Technicians Meeting at

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Agenda Items Notes Actions AFN is this month.  Concerns over potential cuts to NIHB benefits due to increased numbers from McIvor and Qalipu. Will keep everyone updated on NIHB issues that are coming forward Josephine Muxlow:  Working with the Mental Health Nurse at the Healing Lodge at Tobique.  Involved in Wampum training on addictions and trauma. Good to build capacity in the communities  Involved in working with Susan Bear at St. Mary’s on Wellness and Addictions  Steering Committee on Mental Wellness teams, mostly Tui’kn. Currently discussion the evaluation Tracy Lovett:  Introducing herself to the Wellness Committee as the new FASD/IP Nurse at FNIHB and the current projects she is working on. Gena Gallant:  Currently working on 4 new tele-health projects with Bear River, Glooscap will be next in October, Indian Island and Abegweit.  Fall Schedule for the fall Videoconferencing training Sessions has just gone out. Currently recruiting presenters.  Training and Capacity Building: CBRT Training Completed. Privacy training workshops available. 4. MMAHB Evaluation Review of the proposed Terms of Reference for Update – Amanda the MMAHB and the Committees. Information Peters purposes only. Review of the next steps assuming approval of the ToRs by the MMAHB.  Conversation around inclusion of RAPC at the Wellness Committee and reporting to MMAHB. Christiane Poulin will report from RAPC to the Wellness as she will be the co-chair of both committees.  Roles and responsibilities: where did the clause go about committee members staying for the entire meeting or not receiving their travel. This was

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Agenda Items Notes Actions not approved.  Discussion over the $50,000.00 funding limit. Will it be too many issues going to MMAHB?  Need work on communications. 5. Federal First Amanda Peters presented on the Tobacco Nations Tobacco Strategy. Some discussion around criteria etc. Strategy – Heather MacDonald 6. Addictions Meeting  Review of the MMAHB discussion on A7: Amanda to at the MMAHB Sept. how the Addictions and Treatment request to the pre- 20 Centres issue came up at the MMAHB. MMAHB that the  Cindy Ginnish reviewed the activities of Treatment Centre Rising Sun in terms of renewal i.e. presentations on the Prescription Drug Misuse Day Program first day, September at Rising Sun. Staff at the Rising Sun 19, 2012. had to overcome some of the ideas that they maintained that are considered out of date. Have an LPN on staff at the Rising Sun.  It would be good to address the issue of methadone use in the Treatment Centres, how do we get people into treatment? Methadone is bigger than Treatment Centres, it includes legislation, role of physicians.  We have to look at the root of the addictions. Addictions is a symptom of something else and we need to address this. It is not a quick fix. Leadership needs to recognize this. More addictions counselors, more RCMP etc. are not going to resolve this. Have to address root causes of housing, poverty, unemployment, Residential schools, and historical trauma. This message needs to be understood.  Need to understand the importance of support systems. People will not succeed in treatment if their circumstances do not change.  Need to also address the issue that prescription drugs are abused because they are prescribed by physicians and paid for by NIHB or other health insurance programs. Not always illicit drug use. There are two sides to this issue.  Question brought up at MMAHB

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Agenda Items Notes Actions included: Which treatment centres accept methadone clients in residential programs? Rising Sun is not there yet. Cannot accommodate  Clients on methadone need to be counseling to address some of the issues that cause them to be addicts.  Linkages between issues of addiction and FASD. This is an example of unmet needs that needs to be addressed.  Programs need to build capacity. Counselors are getting burnt out, this is difficult work. Address this issue as well. Need resources for the counselors to have their needs met. They are essentially on call 24 hours a day.  Need to use the NIHB statistics on addictions to get the supports to be able to run these programs. It should be ‘needs based.’ Chiefs need to see the numbers associated with methadone and how the treatment centres deal with this.  We need long term mental health counseling in our FN communities.  The RDG of AANDC needs to attend and understand their role in these issues.  Need to have input into the discussions from the youth.  We have come a long way. We have developed our own paradigm for First Nations for treatment etc. Need to recognize this. What works in mainstream does not work but it is moving in a way to allow for more indigenization.  What might be a good exercise is to look at the 17 centres in Canada that currently service methadone clients and understand how they came to this.  Many players in these issues: NNADAP, NNAPF, Tri-partite Forum, Board of Directors consisting of leadership, Atlantic Regional Partnership Committee. Obvious that more communications are needed.  Need to hear success stories and learn from these.

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Agenda Items Notes Actions 7. DUPP  Bev Smith presentation on Prescription A8: Janet Pothier to Funding/Presentation Drug Abuse Prevention and Promotion reword and send out at Elsipogtog. Based on youth and DUPP options to the culture as a protective factor and Health Directors educational tool to spread the message of the dangers of Prescription Drug Abuse etc.  Need to also think about energy drinks as an addiction  The three options presented have been sent out to the Health Directors.  If Wellness opts for another option, it would have to be sent out again for Health Director input  Only 4 Health Directors responded to the request for input identifying Option 1 (3 votes) or 2 (1 Vote) as preferable.  Discussion around capacity of small verses large communities as well as clustering. Sometimes it is effective sometimes it is not.  Communication needs to include the following ; - funding commitments - budget breakdowns and possibilities - clearer options - flexibility - time frames - turn-around time - clearer communication on criteria  There is a recommendation to get the health techs to go back to the HDs to touch base again with the HDs, in addition is to send it out again in mass email, as well as health tech follow up  Decision: all the options will be left as is, as a RFP, with clarification in some areas: flexibility, amounts, timeframes, criteria, no carry over, etc.

- Teleconference will be for next Friday for 9:30 am next Friday, Sept. 14. 8. NAYSPS Will be completed via email. A9: Janet to follow Coordinator up on this Networking Session - Evaluation

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Agenda Items Notes Actions 9 Input for Wellness Completed Subcommittee Report for next MMAHB meeting (September 19 & 20, 2012) 10. Closing Prayer Sally Johnson

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Meeting Information

COMMITTEE: Mental Wellness Committee

DATE: January 8-9, 2013

LOCATION: APC Offices, 153 Willowdale Drive, Dartmouth Nova Scotia

Agenda Items Time Item Presenter 10:00- Opening Prayer, Introductions and Ice Breaker Robin Boychuk, FNIHB 10:30 10:30- Background on MMAHB/MMAHB Evaluation Amanda Peters, APC 11:00 Process 11:00- Review of FNIHB Programs and Resources Wade Were, FNIHB 12:00 12:00-1:00 Lunch 1:00-1:30 MMAHB Cycle (Planning and Communications Amanda Peters, APC 1:30-2:30 Scope of Decision Making Wade Were, FNIHB 2:30-2:45 Break 2:45-3:15 Committee Membership, Activities, and Robin Boychuk, FNIHB Roles/Responsibilities 3:15-3:45 Meeting Processes and Administration Amanda Peters, APC 3:45-3:50 Preparing for First Nations Co-chair Selection Amanda Peters, APC 3:50-4:15 Preparation for Day 2 Activities Robin Boychuk, FNIHB 4:15-4:30 Final Thoughts and Closing DAY 2 9:00-9:15 First Nations Co-Chair Selection First Nations Committee Members 9:15-12:15 Brainstorming Activities for Workplanning Committee. Facilitated Consultant 12:15-1:00 Lunch 1:00-3:00 Brainstorming Activities for Workplanning Committee. Facilitated by Consultant

Notes on the Agenda

1. Documents that will be provided to you include:

 Slide Show from Orientation Session  Terms of Reference for MMAHB Committees  MMAHB Evaluation Report  Contact Sheet for all members of the three (3) Committee and the MMAHB  Elder Care Strategic Plan, Mental Health and Addictions Strategic Plan, Child and Youth Strategic Plan.

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2. To prepare you may want to:

 Review the Guiding Principles Document (http://www.apcfnc.ca/en/health/resources/HealthPrioritiesGuidingPrinciplesFinalVersion May2011.pdf)  Review the Terms of Reference (http://www.apcfnc.ca/en/health/mmahb.asp)  Think about items/issues that you want the committee to be working on  Note that lunch will be provided.

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Mental Wellness Minutes January 8, 2013 APC Office

Attendees: Representing: Voting members: Janet Pothier CMM; Co-Chair Gillian Bailey FNIHB; Co-Chair Peter Birney UNBI Tammy Arsenault MCPEI Notoria Hinks NFLD Non-Voting/Observing members: Chelsea Googoo APC Annette Waterman APC Amanda Peters APC Robin Boychuck FNIHB Peter McGregor FNIHB Charmane Kay FNIHB Josephine Muxlow FNIHB Wade Were FNIHB

Regrets: Laurie Nicholas

Agenda Items Notes Actions Opening Prayer  Josephine Muxlow Welcome &  Amanda Peters and Robin #1: Chelsea will add Introductions: Boychuck made introductions the committee TOR around the table and did an into the packages on icebreaker activity. day 2. Background on  Amanda Peters and Robin #2: Chelsea will add MMAHB/MMAHB Boychuck provided a background the following names Evaluation Process on the MMAHB evaluation to the MMAHB process and the contents of the master contact list: MMAHB orientation package. FN co-chair, Peter MacGregor & Charmane Kay.

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Agenda Items Notes Actions Review of FNIHB  Wade Were reviewed the Programs and FNIHB’s programs and services Resources outlined in the attached MMAHB committee orientation: FNIHB’s role, responsibilities, portfolios and goals. MMAHB Cycle  Amanda Peters presented a detailed description on how the MMAHB cycle works, when meetings take place, and the MMAHB communications. Scope of Decision  Wade Were presented and Making explained a detailed process on how decisions are made between the FN parties and FNIHB. There are 3 levels of decision making: 1. Shared Decision; 2. Funding Decision (includes allocation); 3. Policy and Planning Decision.  Explanation and discussion on the term co-management as different from the financial intervention definition commonly used in First Nations communities. Committee  Robin Boychuck explained the #3: the co-chairs will Membership, membership between the voting present at the RAPC Activities, and members and the non-voting meeting on January Roles/Responsibilities members (includes a 17 and request to representation from the Atlantic have someone from tribal organizations and the RAPC to sit on the FNIHB employees). Robin also mental wellness explained how the committee committee as a activities in detail as well as the permanent observer. roles and responsibilities, the attendance of the voting members and the appointments of the co-chairs.  Discussion about RAPC (see action item #3). Meeting Processes  Amanda Peters explained the and Administration meeting process and administration behind APC (the work of the health policy analyst and the MMAHB coordinator).

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Agenda Items Notes Actions The process includes: deadlines of paperwork, the logistics of the planning of meeting dates, locations, templates and any other additional work provided by APC. Preparing for First  Amanda Peters explained the Nations Co-chair process of the voting of the FN Selection co-chair. The selected co-chair will be chosen for the duration of 2 years. Preparing for Day 2  Robin Boychuck and Amanda Activities explained that a facilitator will attend day 2 of the meeting for brainstorming for the NIHB work plan. Final Thoughts and  Amanda provided a recap on the Closing day’s events.

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POSITION DESCRIPTION

Position Title: MMHAB Coordinator – Chelsea Googoo

Department: Health

Salary:

Term: April 1st, 2013 to March 31st, 2014

Location: APC Head Office, Cole Harbour Reserve, Dartmouth, NS

Position Reports to: Amanda Peters, Senior Health Policy Analyst

Positions Supervised: N/A

Objective

To provide required administrative, logistical, analytical and other support for the Mi’kmaq Maliseet Atlantic Health Board (MMAHB) and related committees.

Position Overview

This position will coordinate all the work related to the MMAHB by providing administrative and logical support with and participate in committees and sub committees meetings.

Essential Functions and Duties

1. Scheduling MMAHB/Subcommittee Meeting Dates, Meeting Notices, booking meeting location, set up catering, preparing meeting packages, agendas, drafting minutes and onsite meeting management; 2. Draft MMAHB Meeting Minutes and emailed to committee members within two weeks after the meeting for review; 3. Revision of minutes and recirculation of approved minutes to committees and communities;

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4. Dissemination of health material to communities, health directors, health technicians and Chiefs; 5. Preparation of Annual MMAHB/committee report; 6. Coordination of the MMAHB committees: MMAHB, Child & Youth, Wellness, Primary Public Health, Co-Chairs, Mental Health and Addictions Networking group and any related additional meetings as needed; 7. Administrative Duties for MMAHB. Report gathering and formatting, preparation of Correspondence, faxing, mailing/emailing, create and maintain a MMAHB filing system, photocopying, maintaining office equipment, ordering office supplies; 8. Ensure that Sharepoint and webpage are up to date as requested by supervisor; 9. Other duties requested by supervisor

Performance Measurements

1. Quality minute generation & consistent standards for meeting coordination; 2. Completion of tasks in timely and professional manner; 3. Qualities of all work as per grammar, spelling, completeness and are timely; 4. Health materials are out to the communities in a timely manner and are accurate; 5. Report submitted to FNIHB is complete and accurate 6. Facilitate teamwork with FNIHB and APC Staff; 7. MMAHB materials are organized and materials are sent out to the communities is accurate and timely; 8. Ability and willingness in assisting when requested. 9. Sharepoint and website are up to date.

Qualifications

Education/Certification:

 Possess a recognized diploma or certificate in office/administrative management/assistance and 1-3 years recent experience working as an Administrative or Office Assistant (a combination of relevant education and experience will also be considered);

Required Knowledge:

 Proficient knowledge of computer programs: Word, Excel, Power Point  Extensive knowledge in communications and minute generation  Some knowledge of the health care systems in Atlantic Canada  1-3 years work experience working with First Nations/organizations, preferably in the area of health  Knowledge of First Nation communities and organizations in the region

Experience Required:

 Demonstrated excellent administrative and organizational skills  Excellent minute taking ability (min. 40 WPM)

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Skills/Abilities

 Excellent computer, oral, organizational and written communications skills  Ability to speak Mi’kmaq, Maliseet or Innu language would be an asset.

Position Requirements

Must possess a valid driver’s permit, have a vehicle, and be willing to travel as required

If all qualifications are equal, preference will be given to persons of Aboriginal ancestry.

Annual Performance Review

Continued employment is also contingent upon your satisfactory performance. To assess your performance, you will be subject to a review in accordance with the APC Human Resources Policy.

ACKNOWLEDGEMENT

I have read the terms and conditions of employment as outlined in this agreement and attached hereto and I accept and agree to such terms and conditions.

______Date: ______

Chelsea Googoo, MMHAB Coordinator

______Date: ______

Amanda Peters, Senior Policy Analyst

______Date: ______

Shawn Holte, Director of Operations

______Date: ______

John G. Paul, Executive Director

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APC Health Individual Work Plan 2010-2015 Chelsea Googoo, MMAHB Coordinator

GOAL ACTIVITIES TIME FRAME ANTICIPATED RESULTS 1.0 Organize MMAHB and related 1.1 Find location for Immediately following the Ensure location and food for meeting Committee meetings (Child and meeting, prepare proper previous meeting when date Youth, Wellness, PHC, CYMHA, contracts for location, and location have been stated Health Technicians and Co-chairs) logistics and catering. Collaborate with SHPA and Legal at APC. 1.2 Send out invitations to At least one month prior to Ensure all members are informed of committee members. meeting date, location of next meeting 1.3 Prepare travel claims Two weeks prior to meeting To ensure all committee members for Chiefs committee are properly reimbursed for their members expenses 1.4 Assist co-chairs / APC One – two weeks prior to Completed agenda staff in preparing agenda meetings 1.5 Collect agenda One week prior to meetings Have the agenda ready ahead of time presentations 1.6 Send out reminders to One week prior to meeting Ensure all members are informed of Chiefs and committee date, location of next meeting member 1.7 Ensure agenda is Two days prior to the meeting Have the agenda to the committee completed and sent to members to review before meeting committee participants 2.0 Follow up to MMAHB and 2.1 Begin preparation for The week following the To ensure location and food for related Committee meetings next meeting (locations, previous meeting when meeting logistics etc.) location and date have been stated. 2.2 Type minutes from One week following the Type minutes while still fresh in meeting and summary of meeting memory Action Items

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GOAL ACTIVITIES TIME FRAME ANTICIPATED RESULTS 2.3 Distribute draft One week following meeting Approval of minutes by co-chairs to minutes to co-chairs for ensure clarity approvals 2.4 Ensure travel claims Within one week of the Ensure committee members are submitted to finance meeting reimbursed. 2.5 Send out reminder to Within 15 days of meeting Ensure committee members have committee members to their forms/invoices/receipts in for submit their travel forms reimbursements. within the 30 day time window 2.6 Distribute finalized Three weeks following the Committee members will be able to minutes to committee meeting review minutes and proceed with members action items 2.7 Ensure that location One week following the To ensure that invoices are properly invoices etc are submitted meeting submitted to finance to finance 3.0 Organize Health Directors See 1.0 and 2.0 See 1.0 and 2.0 See 1.0 and 2.0 Meetings, three times per year 4.0 General maintenance of 4.1 Organizing health files Twice a year Organized filing system for easier health filing system that pertain to MMAHB access. coordinators role

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