APPENDICES (Abridged Version)

Aboriginal Health and Wellness Plan 2002/03 – 2005/06

Interior Health Authority

Submitted to the Ministries of Health Services and Health Planning Original: September 2002 Revised: February 2003

Submitted by Interior Health Authority in Partnership with the Interior Health Aboriginal Health and Wellness Advisory Committe

1 APPENDICES to the INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN 2002/03-2005/06

LIST OF APPENDICES:

APPENDIX A: HISTORICAL BACKGROUND OF ABORIGINAL PEOPLES IN CANADA

APPENDIX B: TERMINOLOGY

APPENDIX C: COPY OF “ABORIGINAL HEALTH CARE ISSUES”

APPENDIX D: COPY OF DRAFT GOALS AND STRATEGIES DEVELOPED BY THE OKANAGAN SIMILKAMEEN HEALTH REGION, ABORIGINAL HEALTH WORKING GROUP

APPENDIX E: COPY OF THE KTUNAXA KINBASKET AND EAST KOOTENAY HEALTH AUTHORITIES: MEMORANDUM OF UNDERSTANDING “HEALTHY PEOPLE IN HEALTHY FAMILIES IN HEALTHY COMMUNITIES”

APPENDIX F: COPY OF LOWER COLUMBIA RIVER ALL COUNCIL REPORT ON AN ABORIGINAL COMMUNITY CAPACITY BUILDING PROJECT

APPENDIX G: MAP OF INTERIOR HEALTH APPENDIX H: LIST OF ABORIGINAL ORGANIZATIONS AND COMMUNITITES WITHIN THE INTERIOR HEALTH BOUNDARY

APPENDIX I: LIMITATIONS OF DATA SOURCES

APPENDIX J: INDIAN RESERVE POPULATION COUNTS WITHIN THE INTERIOR HEALTH

APPENDIX K: STATUS INDIAN AND OTHER POPULATION COUNT FOR BC BY AGE AND GENDER (BC VITAL STATISTICS AGENCY)

APPENDIX L: LIST OF PARTICIPATING ABORIGINAL ORGANIZATIONS AND COMMUNITIES IN THE ABORIGINAL HEALTH AND WELLNESS PLANNING PROCESS

APPENDIX M: COPY OF DRAFT ABORIGINAL HEALTH PLAN BY WEIR CONSULTING (FORMER NORTH OKANAGAN HEALTH REGION)

APPENDIX N: COPY OF DRAFT “SUMMARY REPORT: ABORIGINAL HEALTH AND WELLNESS PLANNING-THOMSPON/CARIBOO/CHILCOTIN HEALTH SERVICE REGION”

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED FEB. 2003 3 APPENDIX O: LIST OF INVITEES TO THE INTERIOR HEALTH AUTHORITY REGIONAL ABORIGINAL CONFERENCE- MAY 6, 2002 AND WORKING GROUP NOTES

APPENDIX P: AHWAC DRAFT TERMS OF REFERENCE

APPENDIX Q: HEALTH SERVICES FUNDED/PROVIDED BY THE FEDERAL GOVERNMENT OF CANADA

APPENDIX R: INFORMATION GATHERING TOOL FOR SERVICES

APPENDIX S: PROPOSED 3 - YEAR OUTCOME TARGETS

APPENDIX T: LOGIC MODEL FOR THE INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN, PROPOSED 3 - YEAR OUTCOME TARGETS

APPENDIX U: ACCOUNTABILITY MAP - LINKING INTERIOR HEALTH OPERATIONS TO THE IH ABORIGINAL HEALTH AND WELLNESS PLAN

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED FEB. 2003 4 APPENDIX A: HISTORICAL BACKGROUND OF ABORIGINAL PEOPLES IN CANADA

Residential Schools

The first Indian residential school was established in Alderville, Ontario in 1849. In 1892, an Order in Council was passed which contained the regulations for the operation of residential schools. From 1920 onwards, school was mandatory for children aged 7-15.

The schools were part of the general assimilationist policy of the government that was explicitly stated even into the 1950’s. Four churches were involved in the operation of the schools on a contractual basis with the federal government: Roman Catholic, orders, Anglican, Presbyterian, and United. It is estimated that about 100,000 children attended the residential schools, about 20 percent of the potential total of status Indian students.

In the early years, the churches explicitly supported the assimilationist goals in running the schools. Thinking began to change in the 1960’s about the harm to children in separating them from their families and the increasingly evident failure of assimilation. The residential schools in Canada The residential schools in Canada separated children from their families and communities, adhered to a strict institutional regimen and religious dogma, punished children for speaking in their traditional language and subjected many First Nation children to varying degrees of verbal, physical and sexual abuse. The results of this residential school policy have left behind a very negative legacy that has contributed to dysfunctional individuals, families and communities, alcoholism and alcohol related deaths, disproportional rates of incarceration, high rates of suicide, and many troubled and angry people and communities.

The positive effects of the residential schools were general academic skills such as math, reading, etc and athletic achievement.

The positive effects do not appear to outweigh the destruction of First Nation families and communities, language, culture, spirituality and a sense of First Nation identity and pride. This is but one of the precedents that has led to the wide range of complicated issues and challenges that our society is facing now. Interior Health is in a better position to understand the Aboriginal history and find positive ways to address Aboriginal health.

Aboriginal Peoples in Canada and the Federal Government/British Crown

In providing an understanding of the past, the following is a historical look at Canada and BC’s relationship with Aboriginal peoples. (Source: http://www.cariboolinks.com/ctc/history.html)

Time What Occurred

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED FEB. 2003 10, 000 Earliest evidence of Aboriginal civilizations in . BC Archaeological evidence found at Soda Creek in the summer of 1995 was carbon dated at approximately 4,300 years ago. Pre 30 million Indigenous people in North America colonial contact AD 1492 Columbus lands in the West Indies 1755 The British Crown established the Indian Department as a branch of the military. This department was created to foster good relations with Indians, and to cultivate military alliances with them. 1763 A Royal Proclamation by King George III promoted and clarified the rights for “native people” regarding their traditional territories and included recognition of specific Indian settlements in Quebec. 1770s- Captain Cook explores West Coast 1780s 1774 Juan Perez Hernandez lands on Vancouver Island’s west coast. 1793 Alexander McKenzie reaches the Pacific via an overland route. 1849 Hudson’s Bay Company (HBC) given imperial grant to settle and colonize Vancouver Island.

1850-54 The colonial Office directs James Douglas to purchase First nations lands, first in his capacity as chief factor of the HBC, ad later as Governor of the Colony. He arranges 14 purchases, now known as the Douglas Treaties, mostly on southern Vancouver Island. 1858-64 Gold seekers flood the BC Interior.

1860s Reserves are set aside. These first reserve allocations were larger than today’s reserves, but these records were destroyed in 1871.

1862-63 Smallpox almost wipes out the nation. Six reserves are left with only a few members who relocate to neighbouring Bands in order to survive.

1867 At the time of confederation, the new British North America Act gave the Federal government legislative authority over “Indians and land reserves for Indians”.

1867- The Administration of Indian and Northern Affairs was handled by various federal 1996 government departments including: • Office of the Secretary of State, • Citizenship and immigration, • Mines and Resources, and • Northern Affairs and Natural Resources.

1869 The Enfranchisement Act- Encouraged, or lured, First Nation citizens to give up their First Nation status in exchange for Canadian style rights such as property rights, the vote etc. This was to encourage integration/assimilation to Canadian society.

1872 BC joined Canada, at the time the Aboriginal people in the province were the majority and still had the right to vote. The new Canadian province, BC, passed a Qualification and Registration of Voters Act of 1872 which stripped natives of the vote in provincial elections. 1874 Indians were registered in anticipation of the Indian Act. 1876 The Indian Act was passed 1881 Indian agency opened in the Cariboo 1884 An Indian Act amendment prohibits the potlatch and sundance. The law was rescinded in 1951.

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED FEB. 2003 1891 St. Joseph’s Mission south of Williams Lake, three generations of Chilcotin, Carrier and Shuswap were taken there in an attempt to make ‘good British subjects’ out of them. 1910 Interior Tribes in BC meet in Spences Bridge to present their views to Sir Wilfrid Laurier, then Prime Minister of Canada, on wanting to settle the land and Aboriginal rights issue. The tribes were the Nl’kapmux, Stl’atl’imx, Okanagan, Tsilqht’in, and Secwepemc. The tribes signed the Sir Wilfrid Laurier Memorial. Laurier promised to take Native issues to privy council for resolution, his defeat in the 1911 election ended that initiative. 1916 The McKenna McBride Commission ruled the size of existing Indian reserves could be unilaterally reduced if Ottawa would obtain consent from the natives, and that other lands would be added. The Native withheld consent stating the lands to be added were almost worthless. The provincial total amount of reserve land shrunk significantly. This led to the “Cut-Off Lands” referred to in specific land claims. 1918 Canadian Women win the right to vote in federal elections in Canada. This does not include Indian Women, or Indian men. 1920 Ottawa enacts Bill 13 which overrode the need for native consent. Canada passes the BC Indian Lands Settlement Act, the McKenna McBride Commission recommendations go ahead reducing reserve land to less than 36% of the total area of BC. Next came Bill 14, empowered the enfranchisement or removal of any Natives from ‘status’, those who went to fight in the wars, worked and lived off reserve were among those who lost their ‘Indian status’ under Bill 14. 1922 Federal legislation is passed-Federal government prosecutes Indians who practice their traditional Potlatch, Bighouse and Longhouse ceremonies. 1927 Provincial legislation is passed- Indians are prohibited from raising money or retaining a lawyer for the purpose of pursuing land claims. 1951 An Indian Act amendment removes major prohibitions against Indians. However, Canada’s control over Indian lands and property, money, local government and Indian status remained. 1960 Indians granted the right to vote in federal and provincial elections. 1966+ The Indian Act was first passed in 1876. Originally, the role of the Department of Indian Affairs and Northern Development was to provide basic services to First Nations. These services included education, housing, road maintenance, water and sewer systems. The current role of the department (now called Indian and Northern Affairs Canada) is to act as an advisory, funding and supportive agency in its relationship with First Nations, Inuit, and northerners.

Some medical services and programs are provided to Aboriginal peoples through Health Canada, currently by the First Nation and Inuit Health Branch. 1969 Trudeau and Chretien’s “White Paper” advocates the abolition of the Indian Act, Department of Indian and Northern Affairs, federal fiduciary responsibility and any and all aspect of Indian status. First Nations political organizations counter with “Citizens Plus” or what is known as the “Red Paper”. The church, DIAND and members of the public support the First Nations political position. The White Paper was not implemented. 1973 The Calder case. The Supreme Court of Canada recognizes the existence of Aboriginal title in principle. Canada initiates a comprehensive Claims process for treaty negotiations across Canada. 1985 Bill C-31 changed the Indian Act and reinstated many First Nations people as Status Indians as per Indian Act registration requirements. 1990 BC joins ongoing federal treaty negotiation with the Nisga’a Tribal Council. The Nisga’a and the Nuu-chah-nulth Tribal Council are the first First Nations to enter into “Health Transfer” with Health Canada, First Nation and Inuit Health Branch. 1991 Chief Justice Allen McEachern of the BC Supreme Court rules that Aboriginal rights in BC were extinguished by pre Confederation legislation. 1993 Delgamuukw decision, BC Court of Appeals overturns the McEachern decision stating that undefined Aboriginal rights continue to exist. 1993 BC Treaty Commission is established to negotiate land issues.

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED FEB. 2003 APPENDIX B: TERMINOLOGY

The following is a list of terms and definitions:1

First Nation: A term that came into common usage in the 1990's to replace the word "Indian", which many people found offensive. Although the term First Nations is used widely, no legal definition of it exists. Among its uses, the term "First Nations peoples" refers to Indian people in Canada, both status and non-status. Many Indian communities have also adopted the term "First nation" to replace the word "Indian band" in the name of their community.

Indian Band: An Indian Band is a group of First Nation people for whom Indian Reservation lands are held in trust by the Crown and Band Support Funding (a form of municipal type of funding) is provided by INAC. The members of a Band or First Nation generally share common values, traditions and practices rooted in their ancestral heritage. For governance, community members of a Band or First Nation, may have accepted the INAC imposed electoral system to choose their Chief and Band Councillors, retained their traditional Hereditary Chief system or a combination of the two.

Inuit: The Inuit are an Aboriginal people in Northern Canada, who live above the tree line in the Northwest Territories and in Northern Quebec and Labrador. The word means "people" in the Inuit language--Inukitut. The singular form of Inuit is Inuk.

Métis: Métis are people of mixed First Nation and European ancestry who identify themselves as Métis people. These people are distinct from First Nations People, Inuit or non-Aboriginal people. The Métis have a unique culture that draws on their diverse ancestral origins, such as Scottish, French, Ojibway and Cree. Most Métis live in the prairie provinces of Manitoba, Saskatchewan, and Alberta, and are seeking a land base in Manitoba and Saskatchewan.

Although BC is not the traditional territory of Métis peoples many have migrated to this province. Métis peoples are also currently in tripartite negotiations with the federal and provincial governments with regard to their health, economic and other community needs. There is no set or consistent registration requirements for Métis as there is for the registration requirements of Status Indians.

Status Indian: A “Status Indian” is an individual that meets the registration requirements of the Indian Act of Indian and Northern Affairs Canada (INAC) and is on their registration list. Between 1850 and 1951, government Indian Agents maintained

1 http://www.ainc-inac.gc.ca/pr/info/info111_e.html

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED FEB. 2003 band membership lists with the names of Indians who met INAC membership requirements. An amendment to the Indian Act in 1951 created the Indian Register. Today many First Nations have their own Band members employed as their Indian Registration Officers. Status Indians have access to certain limited rights and benefits such as on-reserve housing benefits and exemption from federal and provincial taxes in specific situations. Status Indians are not Inuit or Métis.

Non-status Indian: A “non-status Indian” is an Indian person who is not registered under the Indian Act. Possible reasons for not being registered include: their ancestors may have enfranchised to gain a small portion of Band cash entitlement and the vote; their mother may have married a non-native man and lost their Indian Status; their ancestors may not have been registered by an Indian Agent; or a variety of other reasons - the result of a variety of amendments made to the Indian Act or the individual chooses not to be registered under the Act etc.

Treaty Indian: A Treaty Indian is a Status Indian who belongs to a First Nation that signed a treaty with the Crown. The majority of BC Status Indians are not “Treaty Indians” because the lands have not been legally surrendered. Hence the current BC Treaty Commission (BCTC) process.

Reserve: A reserve is land held in trust by the Crown for the use and occupancy of an Indian Band.

Indian Act The Canada federal Legislation, first passed in 1876, that sets out certain federal government obligations, and fiduciary responsibilities and regulates the management of Indian reserve lands. The Act has been amended several times, most recently in 1985.

Tribal Council/Treaty Council A tribal/treaty council is an INAC funded regional affiliation of bands and is based on common political goals, geographic proximity and to some extent, common cultural or family ties. Tribal/Treaty Councils provide additional services to their member tribes such as economic development services, consultant/contractor services etc. that the member tribes would otherwise have to incur the cost of themselves.2

2 Shuswap Nation Tribal Council Brochure.

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED FEB. 2003 APPENDIX G: MAP OF INTERIOR HEALTH

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED FEB. 2003

APPENDIX H: LIST OF ABORIGINAL ORGANIZATIONS AND COMMUNITITES WITHIN THE INTERIOR HEALTH BOUNDARY

ABORIGINAL TRIBAL COUNCILS/AFFILIATIONS WITHIN INTERIOR HEALTH:

Cariboo Tribal Council, Carrier Chilcotin Tribal Council, Williams Lake, BC Williams Lake, BC Tribal Administration, Ktunaxa-Kinbasket Tribal Council, Lytton, BC Cranbrook, BC Tribal Council, Nicola Tribal Council, Lillooet, BC Merritt, BC Nlaka’pamux Nation Tribal Council, , Lytton, BC Westbank, BC Shuswap Nation Tribal Council, Tsilhqot’in National Government, , BC Williams Lake, BC

FIRST NATIONS BANDS WITHIN INTERIOR HEALTH:

Adam’s Lake Indian Band Alexandria Indian Band. Alexis Creek First Nation Chase, BC Williams Lake, BC. Chilanko Forks, BC Affiliation: Shuswap Tribal Council Affiliation: Tsilhqot’in National Affiliation: Tsilqot’in National Government Government. , , Ashcroft, BC. Cache Creek, BC Boston Bar, BC Affiliation: Nlaka’pamux Nation Affiliation: Shuswap Tribal Council Affiliation: Nlaka’pamux Tribal Tribal Council Council , Bridge River Indian Band, Canim Lake Indian Band, Boston Bar, BC Lillooet, BC, 100 Mile House, BC Affiliation: Nlaka’pamux Nation Affiliation: Lillooet Tribal Council Affiliation: Cariboo Tribal Council Tribal Council Canoe Creek Indian Band, Cayoose Creek Indian Band, Esketemic First Nation, Williams Dog Creek, BC Lillooet, BC Lake, B.C Affiliation: Cariboo Tribal Council Affiliation: Lillooet Tribal Council Affiliation:

Fountain Band, , Kamloops Indian Band, Lillooet, BC Clinton, BC Kamloops, BC. Affiliation: Lillooet Tribal Council Affiliation: Affiliation: Shuswap Nation Tribal Council Kanaka Bar Indian Band, Little , Lower Kootenay Indian Band, Lytton, BC, Chase, BC Creston, BC Affiliation: Fraser Canyon Tribal Affiliation: Affiliation: Ktunaxa-Kinbasket Administration Tribal Council Mount Currie Band Council , , Mount Currie, BC Chase, BC Lytton, BC Affiliation: Lillooet Tribal Council Affiliation: Secwepemc Nation Affiliation: Fraser Canyon Tribal Administration , North Thompson Indian Band, , Merritt, BC Barriere, BC Vernon, BC Affiliation: Nicola Tribal Affiliation: Shuswap Nation Tribal Affiliation: Okanagan Nation Association Council Alliance

Oregon Jack Creek Band , , Ashcroft, BC, Oliver, BC Penticton, BC Affiliation: Nlaka’pamux Nation Affiliation: Okanagan Nation Affiliation: Okanagan Nation Tribal council Alliance Alliance Smahquam First Nation, Seton Lake Band, Shakan Indian Band,

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED MAR. 2003 Mount Currie, BC Shalalth, BC Merritt, BC Affiliation: Affiliation: Lillooet Tribal Council Affiliation: Nicola Tribal Council Shuswap Indian Band, , , Invermere, BC Lytton, BC Savona, BC Affiliation: Ktunaxa-Kinbasket Affiliation: Nicola Tribal Council Affiliation: Shuswap Nation Tribal Tribal Council Council Shuppah Indian Band, Soda Creek Indian Band, Indian Band, Lytton, BC Williams Lake, BC Enderby, BC Affiliation: Fraser Canyon Tribal Affiliation: Cariboo Tribal Council Affiliation: Shuswap Nation Tribal Administration Council St. Mary’s Indian Band, T’it’q’et Administration, Tl’etinqox’-t’in Government Office, Cranbrook, BC Lillooet, BC Alexis Creek, BC Affiliation: Ktunaxa-Kinbsket Affiliation: Lillooet Tribal Council Affiliation: Tsillhqot’in National Tribal Council Government Tobacco Plains Indian Band, Toosey Indian Band, Ts’kw’aylaxw First Nation, Grassmere, BC Riske Creek, BC Cache Creek, BC Affiliation: Ktunaxa-Kinbasket Affiliation: Carrier-Chilcotin Tribal Affiliation: Lillooet Tribal Council Tribal Council Council Ulkatcho First Nations, , Upper Similkameen Indian Band, Anahim Lake, BC Merritt, BC Keremeos, BC Affiliation: Carrier Chilcotin Tribal Affiliation: Nicola Tribal Council, Affiliation; Okanagan Tribal Council Okanagan Nation Alliance. Council , Whispering Pines, Williams Lake Indian Band, Kelowna, BC Kamloops: BC Williams Lake, BC Affiliation: Okanagan Nation Affiliation: Shuswap Nation Tribal Affiliation: Cariboo Tribal Council Alliance Council Xeni Gwet’in First Nations Tl’etinqox-t’in (Anaham) Band Yunesit’in (Stone) , Affiliation: Affiliation: Nemaiah Valley, BC Affiliation: Tsilhqot’in National Government Columbia Lake Band Lower Similkameen Indian Band Windermere, BC Keremeos, BC Affiliation: Affiliation: Okanagan Tribal Ktunaxa/Kinbasket Tribal Council Council

MÉTIS ORGANIZATIONS WITHIN INTERIOR HEALTH:

Cariboo Chilcotin Métis Interior Métis Circle, Kelowna Métis Association, Association, Kamloops, BC Kelowna, BC Williams lake, BC Kootenay Region Métis Two Rivers Métis Society, Association, Kamloops, BC Cranbrook, BC

ABORIGINAL ORGANIZATIONS WITHIN INTERIOR HEALTH:

Cariboo Chilcotin Aboriginal Training and Education Nicola Valley Institute of Technology, Centre, Merritt, BC Williams Lake, BC Tribal affiliation: Nicola Tribal Association Tribal Affiliations: Carrier, Chilcotin, Shuswap and Urban BC Aboriginal Network on Disability Society Okanagan Aboriginal AIDS Society Kelowna, BC

Okanagan Indian Education Resource Society. Secwepemc Cultural Education Society, Penticton, BC. Kamloops, BC

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED MAR. 2003

ABORIGINAL FAMILY AND YOUTH SERVICES WITHIN INTERIOR HEALTH:

Anaham Elders Care Home Society, Kelowna Métis Family Services, Williams Lake, BC Kelowna, BC Knucwentwecw Society, Shuswap Family Resource and Referral Centre, Williams Lake, BC Salmon Arm, BC Women Warriors Against Violence, Vernon, BC

ABORIGINAL FRIENDSHIP CENTRES WITHIN INTERIOR HEALTH:

Cariboo Friendship Society, Conayt Friendship Society, Williams Lake, BC Merritt, BC First Nations Friendship Centre, Interior Indian Friendship Centre, Vernon, BC Kamloops, BC Ki-Low-Na Friendship Society, Lillooet Friendship Centre, Kelowna, BC Lillooet, BC South Okanagan Urban Native Delegation Society, Penticton, BC

ABORIGINAL HEALTH SERVICES WITHIN INTERIOR HEALTH:

Adams Lake Health Centre, First Nations Emergency Services Society of BC Chase, BC Kelowna, BC Nenqayni Treatment Centre Society, Interior Native Alcohol and Drug Abuse Society, Williams Lake, BC Armstrong, BC Scw’exmx Community Health Services Society, Three Corners Health Services Society, Merritt, BC Williams Lake, BC Sexqueltqin Health Centre, White Feather Health Clinic, Chase, BC 100 Mile House, BC Heskw’en’scutxe Health Centre, Ki-Li-Lu Urban Native Health Centre, Lytton, BC Kamloops, BC Qwemtsin Health Society, Lillooet Health Centre, Kamloops, BC Lillooet, BC Lytton Health Centre, Simpcw Health Centre, Lytton, BC Barriere, BC Seton Lake Health Centre, Xaxli’p Health Society, Seton Portage, BC Lillooet, BC Alexis Creek Health Centre, Esketemc Health Centre, Alexis Creek, BC Williams Lake, BC 7Aqam Community Centre Home 7Akisqnuk Health Resource Centre Anahim Lake Nursing Station, Pine Acres Home, Anahim Lake, BC Westbank, BC Round Lake Treatment Centre, Armstrong, BC

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED MAR. 2003 OTHER ABORIGINAL ORGANIZATIONS WITHIN INTERIOR HEALTH:

Indigenous Arts Service Organization, Sen’klip Native Theatre Company, Penticton, BC Vernon, BC All Nations Development Corporation, Community Future Development Corporation of Kamloops, BC Central Interior First Nations, Kamloops, BC Dene Development Corporation, First Nations Agricultural Lending Association, Williams Lake, BC Kamloops, BC Indian Taxation Advisory Board, Lancaster Leasing, Kamloops, BC Kamloops, BC Punky Lake Wilderness Camp Society, Kla-How-Ya Communications, Williams Lake, BC Vernon, BC Secwepemc News, BC Native Women’s Society, Kamloops, BC Keremeos, BC Lillooet Employment Centre, Aqanttanam Housing Society, Lillooet, BC Cranbrook, BC Conayt Housing Authority, Okanagan Métis and Aboriginal Housing Society, Merritt, BC Kelowna, BC Vernon UNN Housing Society, Nenqay Deni Yajeelhtig Law Centre, Vernon, BC Williams Lake, BC Nicola Valley Native Community Legal Assistance Native Courtworker and Counselling Association of Society, BC Merritt, BC Cranbrook office, Cranbrook, BC Native Courtworker and Counselling Association of Native Courtworkers and Counselling Association of BC BC Kamloops Regional Office, Williams Lake Office, Kamloops, BC Williams Lake, BC Native Courtworker and Counselling Association of Native Courtworker and Counselling Association of BC BC Vernon Office, Penticton Office, Vernon, BC Penticton, BC Lower Columbia River All First Nations’ Council Castlegar, BC

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED MAR. 2003 APPENDIX I: LIMITATIONS OF DATA SOURCES

The 1996 and 2001 Canada Census data presented in this report represent the Aboriginal population. The strengths of using this information are that it includes all Aboriginal people and it provides a large amount of information on population characteristics. However, the 1996 Census excluded 77 Indian Reserves or settlements with a population of about 44,000 people in Canada and it is unknown whether these people were actually in BC. This compounded with the fact that many Aboriginal people choose not to participate in the Census indicates that the Census underestimated the number of Aboriginal people in Canada and possibly in BC. It should also be noted that the population characteristics for total population are estimated from a sample of 20 percent of the population who received the long form in the census.3

The Vital Statistics information data provides the statistics for the Status Indian Population of BC. The Vital Statistics information for the Status Indian Population of BC is received from the British Columbia Vital Statistics Agency (Regional Analysis of Health Statistics for Status Indians in British Columbia, 1991-1999, 2001). The strengths of using this information are that it includes 100 percent of the Status Indian Population. However, there are three weaknesses of using this information. Firstly, it excludes, according to the 1996 census, 33 percent of the Aboriginal Population. Secondly, there is the possible exclusion of Status Indians who have coverage for MSP through spouse or employer’s MSP coverage.4 Thirdly, it does not represent the Métis population. Finally, the First Nations that have taken on the First Nation and Inuit Health Branch Health Transfer process to deliver the Non-Insured Health Benefit Program are not provided with the administration budget or the support to continue the health data collection and record system that Health Canada’s FNIHB has had budgeted in its delivery. Thus, an important tracking system is lost.

The current projections in the Registered Indian Population Projections for Canada and Regions are based on the 1998 Indian Register. The Indian Register is based on the registration of individuals who are entitled to be registered according to the Indian, who have applied to be registered, and whose entitlement has been verified. It differs for the Census of Population data in that it takes into account all individuals registered under the Indian Act, including Registered Indians institutions, and those residing outside of Canada and it is not based on self-reporting.

3 http://www.statcan.ca 4 http://www.vs.gov.bc.ca/stats/indian/hrindian/pop.html#fig4

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED FEB. 2003 APPENDIX J: INDIAN RESERVE POPULATION COUNTS WITHIN THE INTERIOR HEALTH Source: Statistics Canada Census population 2001

Statistics Canada Census Population 2001- Note: Not all Indian Reserves participate in the census Indian Reserves Count Indian Reserves Count Indian Reserves Count Ashcroft IR 4 77 Fountain 11 IR 5 Nicheyeah 25 IR 15 Spences Bridge 4 IR 20 Fountain 12 IR 5 Kitzowit 20 IR 23 Spences Bridge 4C IR 5 Fountain Creek 8 IR 5 Skwayaynope 26 IR 5 Pavillion 1 IR 0 Cayoosh Creek 1 IR 69 Skuppah 4 IR 10 Upper Nepa 6 IR 5 Chilhil 6 IR 49 Inklyuhkinatko 2 IR 48 Seah 5 IR 24 Towinock 2 IR 10 Siska Flat 3 IR 95 105 Mile Post 2 IR 10 Nesikep 6 IR 10 Siska Flat 8 IR 34 Upper Hat Creek 1 IR 28 McCartney's Flat 4 IR 33 Lillooet 1 IR 197 Bonaparte 3 IR 129 Pashilqua 2 IR 35 Bridge River 1 IR 214 Lower Hat Creek 2 IR 50 Seton Lake 5 IR 5 Fountain 1 IR 159 High Bar 1 IR 5 Slosh 1 IR 174 Fountain 3 IR 10 Canoe Creek 1 IR 59 Mission 5 IR 27 Fountain 10 IR 10 Canoe Creek 2 IR 64 Neskonlith 1 IR 32 Tobacco Plains IR 82 Lytton 4e IR 10 Neskonlith 2 IR 107 Osoyoos 1 IR 567 Lytton 9a IR 56 Sahhaltkum 4 IR 268 Chopka 7 & 8 IR 48 Kumcheen 1 IR 37 Shuswap IR 176 Lower Similkameen 2 IR 48 Kloklowuck 7 IR 5 Squilax Chum Creek 2 IR 83 Alexis 9 IR 15 Shackan 11 IR 66 Scotch Creek 4 IR 29 Ashnola 10 IR 62 Kanaka Bar 1A IR 53 Louis Creek 4 IR 22 Chuchuwayha 2 IR 65 Kanaka Bar 2 IR 10 Squaam 2 IR 10 Adams Lake IR 370 Nicomen 1 IR 42 North Thompson 1 IR 237 Alexandria 1IR 10 Nickel Palm 4 IR 10 Nooaitch 10 IR 119 Alexandria 3a IR 26 Tsaukan 12 IR 5 Joeyaska 2 IR 37 Albert Flat 5 IR 21 Yawaucht 4 IR 10 Coldwater 1 IR 263 Kamloops 1 IR 1,410 Spintium Flat 3 IR 5 Paul's Basin 2 IR 16 Kootenay 1 166 Halhalaeden 14 IR 5 Hamilton Creek IR 0 Mount Currie 10 183 Halhalaeden 14A IR 5 Nicola Lake 1 IR 155 Deep Creek 2 120 Inkluckcheen 21 IR 131 Douglas Lake 3 IR 171 Williams Lake 1 273 Stryen 9 IR 27 Nicola Mameet 1 IR 442 Johny Sticks 2 15 Nuuautin 2 IR 119 Canim Lake 1 IR 232 Sandy Harry 4 0 Keetlekut 22 IR 10 Canim Lake 2 IR 15 Alkali Lake 1, 4A 401 Nohomeen 23 IR 10 Dog Creek 1 IR 100 Windy Mouth 7 0 Klickkumcheen 18 IR 101 Dog Creek 2 IR 44 Ulkatcho 13 0 Klahkamich 17 IR 79 Creston 1 IR 122 Towdystan Lake 3 10 Papyum 27 IR 39 Columbia Lake 3 IR 165 Seymour Meadows 19 0 Mount Currie 10 117 Baptiste Meadow 2 5 Tsunnia Lake 5 0 Mount Currie 6 704 Stone 1 238 Tanakut 4 21 Mount Currie 8 50 Anahim's Flat 386 Chilko LakeLohbiee 3 77 Okanagan 1 (Part) 1,800 Toby's Meadow 0 Garden 2 5 Penticton 1 IR 901 Puntzi Lake 2 0 Tsinstikeptum 9 5022 Skeetchestn 241 Agats Meadow 8 5 Tsinstikeptum 10 856 Soda Creek 1 IR 55 Charley Boy's meadow 5 North Bay 5 51

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED FEB. 2003 Toosey 1 IR 100 Alexis Creek 0 Salmon River 1 34 Switsemalph 3 63 Quaaout 1 230 Hustalen 1 26 Switsemalph 6 115 Bummers Flat 6 0 Isidore's Ranch 0 Cassimayooks 5 5 Blind Creek 6 23 Nesuch 3 88 Nequatque 1 153 Nequatque 2 15 Nequatque 3A 5

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED FEB. 2003 APPENDIX K: STATUS INDIAN AND OTHER POPULATION COUNT FOR BC BY AGE AND GENDER (BC VITAL STATISTICS AGENCY)

Population Pyramid Status Indian and Other B.C Residents British Columbia, 1999

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED FEB. 2003 APPENDIX L: LIST OF PARTICIPATING ABORIGINAL ORGANIZATIONS AND COMMUNITIES IN THE ABORIGINAL HEALTH AND WELLNESS PLANNING PROCESS

Table representing the Health Service Areas and the Aboriginal communities or organizations that have identified participants in the health planning process. Thompson Cariboo Shuswap Okanagan

♦ Three Corners Health Services Society (Williams ♦ Adam’s Lake Band Lake) ♦ First Nations Friendship Centre (Vernon) ♦ Little Shuswap Indian Band ♦ Little Shuswap Indian Band ♦ Lytton First Nations Health Services ♦ Okanagan Indian Band ♦ Sexqeltqin Health Centre (Adams Lake) ♦ Neskonlith Indian Band ♦ Qwemtsin Health Society (Shuswap) ♦ Spallumcheen Indiana Band ♦ Kamloops Aboriginal Employment Services ♦ Vernon & District Métis Association (Kamloops) ♦ Lower Similkimeen Indian Band ♦ Ki-Li-Lu Urban Native Health Centre ♦ Penticton Indian Band ♦ TOKO Aboriginal Health Council (TOKO AHC ♦ Okanagan Indian Band now defunct) ♦ TOKO Aboriginal Health Council ♦ Fraser Canyon Tribal Administration ♦ Osoyoos Indian Band ♦ Bonaparte First Nation ♦ Upper Similkameen Indian Band ♦ Canoe Creek First Nation ♦ Westbank First Nation ♦ Coldwater First Nation ♦ BC Aboriginal Network on Disability Society ♦ Interior Indian Friendship Society ♦ Ki’Low-Na Friendship Society ♦ Kamloops Indian Band ♦ Okanagan Aboriginal AIDS Society ♦ Skeetchestn Indian Band ♦ Okanagan Nation Alliance ♦ Simpcw Health Board (Barriere) ♦ South Okanagan Urban Native Delegation ♦ Pavilion Band Society ♦ Lower Nicola Band ♦ Nicola Valley Institute of Technology ♦ Conayt Friendship Society (Merritt) ♦ Upper Nicola Indian Band ♦ Aboriginal Employment Services (Merritt) ♦ Han Knakst Tsitxw Houses (Lytton) ♦ Heskw’en’scutxe Health Centre ♦ Nooaitch (Lower Nicola) ♦ Scw’exmx Community Health Services Society ♦ Provincial Residential School Project (Kamloops) ♦ CFDC of Central Interior Indians ♦ Siska Band ♦ T’it’q’et Lillooet Band ♦ Canim Lake Kootenay Kootenay Boundary

♦ St. Mary’s Indian Band ♦ Lower Columbia River All First Nations Council ♦ Columbia Lake Indian Band ♦ Kootenay Region Métis Association ♦ Shuswap Indian Band ♦ Tobacco Plains Indian Band ♦ Lower Kootenay Indian Band ♦ Ktunaxa Kinbasket Tribal Council ♦ Kootenay Region Métis Association

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED FEB. 2003 APPENDIX O: LIST OF INVITEES TO THE INTERIOR HEALTH AUTHORITY REGIONAL ABORIGINAL CONFERENCE- MAY 6, 2002 AND WORKING GROUP NOTES

Name Organization Sarah Spring Stump Abraham’s Lodge and Care Society Ms. Annette Jensen Ms. Toby Reinhart Akisqnuk Health Centre Ms. Anita Dick Ashcroft Indian Band Ms. Joanne Smeeton Ashcroft Métis Association Bonaparte Indian Band Ms. Terri Anne Davidson Boothroyd Indian Band Chief Yvonne Andrew Boston Bar Indian Band Chief Dave Terry Bridge River Indian Band Brian Pugh Marilyn Camille Canoe Creek Indian Band Anita Landry Cariboo Chilcotin Métis Association Marg Ahdemer Cariboo Friendship Society Karen Hewitt ? Cariboo Tribal Council ? Carrier Chilcotin Tribal Council Ms. Trudy Redan Cayoose Creek Indian Band Ms. Betty Spence Clinton Elementary School Ms. Christine Upfold Ms. Patsy Nicholas Columbia Lake Indian Band Ms. Tina Marie Christian Community Health Associates of B.C. Mr. Dennis Francis Conayt Friendship Society Ms. Pearl Hewitt Cook’s Ferry Indian Band ? Esketemc First Nation Ms. Vivian Grinder First Nations Friendship Society Ms Wendy Antoine First Nations Friendship Society Ms. Madeline Lanaro Fraser Canyon Tribal Administration Ms. Joan Holmes Grand Forks Métis Association Ms. Debbie Abbott Hans Knakst Tsitxw Ms. Carol McLeod Heskw’en’scutxe Health Services Chief Gordon Prosper High Bar Indian Band Ms. Delphine Terbasket Interior Indian Friendship Society Ms. Louisa Celesta Interior Indian Friendship Society Ms. Deborah Canada Interior Indian Friendship Society Mr. George Haineault Interior Métis Circle Ms. Joan Miller Kamloops Indian Band Ms. Rhonda Nicholas Kamloops Native Housing Society Ms. Arlene Quinn Kanaka Bar Indian Band Board of Directors Kelowna Native Housing Society Ms. Judith Goodsky Ki-Low-Na Friendship Society Ms. Renée Hetu Ki-Low-Na Friendship Society Ms. Linda Korhorst Kootenay Region Métis Association ? Ktunaxa Independent School Society Ms. Cecelia Teneese Ktunaxa Kinbasket Tribal Association Ms. Agnes McCoy Ktunaxa Kinbasket Tribal Association Ms. Anne Jimmie Ktunaxa Kinbasket Wellness Centre Ms. Mary Basil Ktunaxa Kinbasket Wellness Society Ms. Charlene Yow Ku-Li-Lu Native Health Centre Ms. Deanna Paul Lillooet Friendship Centre Ms. Susan James Lillooet Tribal Council Ms. Wendy Wilson Little Hands of Friendship Native Day-care Centre Ms. Lenora Fletcher Little Shuswap Indian Band Ms. Cheryl Warman Lower Kootenay Indian Band

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED FEB. 2003 Ms. Linda Johnson Lower Kootenay Indian Band Mr. Maury Wale Mr. Keith Jager Lower Nicola Indian Band Mr. Jim McArthur Lower Similkameen Indian Band Mr. Byron Spinks Board of Directors Merritt and District Métis Association ? Native Courtworkers and Counselling Association ? Nenqayni Treatment Centre Ms. Leigh Ann Edwards Neskonlith Indian Band ? Nlaka’pamux Services Society Mr. Peter Viahos Nicola Native Lodge Society Mr. George Saddleman Nicola Tribal Association Mr. Forest Funmaker Nicola Valley Institute of Technology Ms. Brenda Bannerman Nicola Valley Institute of Technology Ms. Arlene Quinn Nicomen Indian Band Ms. Nita Walkem Niha’7kapmux Child and Family Services Ms. Matilda Fenton Niha’7kapmux Child and Family Services Ms. Jenna John North Thompson Indian Band Mr. Eddie Celesta North Thompson Indian Band Board of Directors North Thompson Métis Association Mr. Daryle Roberts Okanagan Aboriginal AIDS Society Mr. Jack Spotted Eagle Okanagan Indian Band Ms. Pauline Terbasket Okanagan Nation Alliance Ms Sandy Pasco Oregon Jack Creek Indian Band Ms. Veronica McGinnis Osoyoos Indian Band Ms. Ramona Louis Osoyoos Indian Band Mr. Dave Jones Penticton Indian Band Mr. Emory Gabriel Penticton Indian Band Ms. Betty Carswell Q’wemtsin Health Society Ms. Marlena Dolan Rainbow Productions Society Mr. Wayne Christian Round Lake Treatment Centre Ms. Vivian Birch-Jones School District 73 Goldtrail Ms. Jackie Robinson Scw’exmx Community Health Services Society Mr. Robert Simon Secwepemc Cultural Education Society Ms. Gladys Arnouse Sexqeitqin Health Centre Shackan Indian Band Ms. Dorothy Warbrick Shuswap Indian Band Mr. Dave Monture Shuswap Nation Tribal Council Chief and Council Siska Indian Band Ms. Jennifer Camille Skeetchestn Indian Band Ms. Arlene Quinn Soda Creek First Nation Mr. Gordon Bird SOUNDS Friendship Centre Ms. Joyce Gray Kennedy SOUNDS Friendship Centre Ms. Holly Dalgleish Ms. Therese Adam Spallumcheen Indian Band Ms. Tanya Francis St. Mary’s Indian Band Mr. Larry York St. Mary’s Indian Band Ms. Rose Pierre T’lt’qet Administration Jennie Walker Three Corners Health Services Society Ms. Pat Floyd Tobacco Plains Indian Band Mr. Leo Porter Ts’kw’aylaxw First Nation Tsilhqot’in National Government Mr. Dwayne Tom Upper Nicola Indian Band Ms. Gerry Fraser Upper Similkameen Indian Band Ms. Leona McKay Upper Statimc Language, Culture and Education Ms. Margaret Eli Westbank First Nation Ms. Colleen LeBourdais Whispering Pine Indian Band

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED FEB. 2003 Yvette Sellars Williams Lake Indian Band Northeast Aboriginal Health Council Ms. Marlene Swears, President Cariboo Chilcotin Métis Association Ms. Donna Cooper Tl’Etinquotin Band Office Ms. Jeanette Mountain Xaxl’ip Nation

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED FEB. 2003

APPENDIX P: AHWAC TERMS OF REFERENCE (March 18, 2003)

PREAMBLE: • Interior Health and the Aboriginal Health and Wellness Advisory Committee recognizes that the Aboriginal Community asserts an inherent right with respect to jurisdiction over the health and well being of its regional Aboriginal citizens. • Nothing in these Terms of Reference shall be interpreted in a manner, which extinguishes, abrogates or diminishes inherent Aboriginal or treaty rights, including Aboriginal title, which is protected under Section 35 of the Constitution Act, 1982. • The dialogue process under these Terms of Reference is not intended to displace the right of the Aboriginal Community and its member Bands to be consulted by the Crown. • Nothing in these Terms of Reference shall be interpreted in a manner that implies endorsement or acceptance of provincial legislation and policies by the Aboriginal Community and its member Bands.

MISSION STATEMENT:

To create a respectful, trusting, responsible partnership between Aboriginal People and Interior Health to support the development of a holistic health and wellness system which is responsive to the needs of the Aboriginal Community.

PURPOSE: ______

The Interior Health, Aboriginal Health and Wellness Advisory Committee (AHWAC) will fulfil their mission by providing advice and direction to the Interior Health Senior Executive Team in the following areas:

• Strategic planning • Networking • Communication • Evaluation • Policy development • Proposal Review and recommendations.

ACCOUNTABILITY

The Aboriginal Health and Wellness Advisory Committee is the formal link between IH and the Aboriginal communities at the strategic directions / policies level. All Aboriginal People are represented and Committee members are accountable to those communities. To ensure that the diverse cultures and interests of the Aboriginal People of Interior Health are realized, the Advisory committee is comprised of Representatives of each Nation within Interior Health:

• Ktunaxa • Secwepemc North

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED MAR. 2003 • Secwepemc South • Nlaka’Pamux • St’Wixt • Okanagan • Sit’atl’imx • Carrier • Tsilqot’in • Metis

Representatives of Urban Aboriginal Organizations:

• Urban Kamloops • Urban West Kootenays • Urban Okanagan • Urban Williams Lake

To maintain strong connections to the Board of Directors, the Senior Executive Team and Interior Health staff, the following non-voting members will be part of the Aboriginal Health and Wellness Advisory Committee:

• Two Interior Health Board Members • Medical Health Officer Responsible for Aboriginal Health Planning • Aboriginal Strategies Coordinator • Other staff as determined by the Committee.

A Letter of Endorsement for the representative to the Committee is required either by Band Council Resolution, Tribal Council Resolution or Board motion. Representatives are appointed to the committee for two-year terms.

ALTERNATE REPRESENTATIVES:

Should an Aboriginal community choose t have an alternate representative, who will attend in the absence of the assigned representatives, the following will apply:

• The representative community or organization must select an alternate representative through the same process of appointment conducted for assigned representatives, by Band Council Resolution, Tribal Council Resolution or Board motion. • To ensure continuity in decision-making, one consistent alternate per community/organization will be designated. • Alternate representatives must be well briefed prior to attending meetings and must be kept informed of the work of the Committee on an on-going basis. • An alternate representative may attend, with prior notice, any Committee meeting as a guest at no cost to the Interior Health Authority.

VALID MEETING:

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED MAR. 2003 A valid meeting will require a minimum of five voting members in attendance. Business will be conducted by consensus.

MEETINGS-FREQUENCY AND LOCATION:

• Meetings will be scheduled as required with a minimum of four/annually. • Notifications of the date and time of the next meeting will be done at least two weeks in advance. • One meeting per year will be conducted with representatives and their alternates in attendance. • Where representatives or alternates have missed three consecutive meetings, or there has been no representation at any meetings, notification will be sent to the supporting organization. • Videoconferencing will be used wherever feasible.

COORDINATION OF MEETINGS:

The committee at the meeting prior to it will decide the Chair of the upcoming Advisory Committee Meeting.

The Chair of the previous meeting and the chair of the upcoming meeting will work with Interior health staff to set the agenda for that upcoming meeting.

Interior Health will be responsible for the technical and administrative (recording secretary) support of scheduled meetings.

FUNCTIONS:

The Aboriginal Health and Wellness Advisory Committee will perform the following functions:

Strategic Planning

The AHWAC will operate with the principle of Strategic Planning for Aboriginal Health. The AHWSC will regularly review information, statistics, etc. from various Aboriginal health stakeholders. The AHWAC will discuss and prioritize Aboriginal health issues and challenges and work with Interior Health to seek out other provincial, federal and other Aboriginal health stakeholders and partners to develop strategies and initiatives to improve Aboriginal health status. The AHWAC will include human resource planning throughout its strategic planning function to ensure that Aboriginal people are working in the health care system.

Networking

The AHWAC will ensure the establishment of Aboriginal Health Liaisons. • Provide informed data on Aboriginal health related matters.

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED MAR. 2003 • Take an active role in facilitating the dissemination of information on Aboriginal Health related issues and services including: o Sharing knowledge and resources to all stakeholders involved in Aboriginal Health. o Building community involvement and strengthening partnerships.

Communication

The AHWAC will • Develop and implement a communication plan that provides direction on how improvement of Health of Aboriginal People will be addressed. • Promote awareness of Aboriginal health and provide all stakeholders involved with any necessary information and correspondence resulting from Advisory Committee meetings.

Evaluation:

The AHWAC will work with staff of Interior Health to follow policy and procedure developed for evaluation of implementation of the Aboriginal Health and Wellness Plan.

Policy Development:

The AHWAC will work in partnership with the Interior Health staff to develop an Aboriginal Health and Wellness Advisory Committee Policy and Procedures Manual that will ensure transparent and equitable processes.

Proposal Review and Recommendation:

In partnership with Interior Health, the AHWAC will review and make recommendations on all targeted Aboriginal funds.

The AHWAC will ensure the most efficient use of resources to achieve the most effective outcomes.

The AHWAC will work with Interior Health to identify opportunities and/or potential partnerships for financial resources and programs to assist the AHWAC achieve its purpose.

CONFLICT OF INTEREST:

The Interior Health and Wellness Advisory Committee will follow the “Guidelines for Conduct” as per the Government of BC Board Resourcing and Development Office.

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED MAR. 2003 APPENDIX Q: HEALTH SERVICES FUNDED/PROVIDED BY THE FEDERAL GOVERNMENT OF CANADA

Health Related programs by Health Canada, First Nations and Inuit Health Branch (FNIHB) and Indian and Northern Affairs Canada

Sources: First Nations and Inuit Health Branch Website and Regional Health Authorities Handbook on Aboriginal Health

Health Canada FNIHB The FNIHB (formerly the Medical Services Branch), a division of Health Canada, works with First Nations and Inuit people to improve and maintain the health of Aboriginal peoples.5 It is the federal agency responsible for the provision of the non-Insured health benefits to Inuit people and Status Indians on and off reserve. FNIHB shares responsibility for the health status of First Nations with provincial and territorial ministries of health, and with First Nations and Inuit communities. The mandate of the FNIHB is: • To ensure the availability of, or access to, health services for First Nations and Inuit communities; • To assist First Nations and Inuit communities in addressing health barriers, disease threats, and to attain a level of health comparable to that of other Canadians living in similar locations; and • To build strong partnerships with First Nations and Inuit people to improve the health system.

The current priorities for FNIHB are: • To manage the cost effective delivery of health services within the fiscal limits of the First Nations and Inuit Health Funding Envelope; • To transfer existing health resources to First Nations and Inuit control within a time-frame to be determined by them; • To support action on health status inequalities affecting First Nations and Inuit communities, according to their identified priorities; and • To establish a renewed relationship with First Nations and Inuit people.

Health Related Programs and Services

The FNIHB is continuing to undergo a dramatic change as they have shifted from being a direct service provider to being a funder of programs, program strategist and analyst and advisor.

The FNIHB’s focus for some years has been to transfer the authority for community based health programs and services to the control of First Nations and Inuit communities and organizations. As part of transfer, First Nations develop their own Community Health Plans and gain freedom and authority to modify programs and services to fit their own priorities, within established funding limits. The FNIHB Health transfer program to First nation communities

5 http://www.hc-sc.gc.ca/FNIHB-dgspni/fnihb/about_fnihb.htm#About the FNIHB

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED FEB. 2003 allows First Nations to act as delegated Authorities in the delivery of their program dollars for the NIHB program. Upon entering into Health Transfer, a First nation receives the NIHB program dollars only and becomes responsible for the incurred costs of administration, insurance, liability, etc. on its own. The Health Transfer Agreements are negotiated and renewed in five year terms.

Community Based programs may be general programs delivered to all First Nations, or project-oriented involving competitions for limited funding. Examples of community based programs include:

First Nations Head Start on Reserve- this program is designed to help on reserve Status Indian children aged six and under develop their full potential by meeting their emotional, social, health, nutritional and psychological needs. The program encourages early childhood development strategies designed and controlled by Aboriginal communities. Projects are encouraged to have the following program components: • culture and language; • education; • health promotion; • nutrition; • social support; and • parental involvement.

There is an equivalent Head Start Program for off reserve First Nation, Métis and Inuit children in urban communities. Health Canada’s Population and Public Health Branch (PPHB) has an Aboriginal Head Start program. There are approximately eight sites in the province for urban Aboriginal children

Alcohol and Drug Treatment Services- The goal of the National Native Alcohol and Drug Abuse Program (NNADAP) is to support First Nations and Inuit people and their communities in establishing and operating programs aimed at arresting and off-setting high levels of alcohol, drug, and solvent abuse among their target populations living on-reserve. This program has two parts: prevention and treatment. Community-based prevention dollars have been fully transferred to First Nations’ Management. These funds are per capita based. If there is a sufficient population base and the funds are adequate, the can be used to employ substance abuse counsellors to provide education, counselling, assessment, and referral services to detox, recovery centres or to identified First nation on-reserve Treatment Centres. If funds are not significant, the community may request some outreach services from established agencies such as Friendship centres of possibly contract addictions services. On-reserve Treatment centres in British Columbia include: • Carrier Sekani Family Services Treatment Centre-Prince George, BC • Haisla Support and Recovery Centre-Kitamaat Village, BC • Hey’-Way’=Noqu’ Healing Circle for Addictions-Vancouver, BC. • Kakawis Family Development Centre-Tofino, BC • Ktunaxa/Kinbasket Wellness Centre-Creston, BC • Namgis Treatment Centre-Alert Bay, BC

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED FEB. 2003 • Nenqayni Treatment Centre-Williams Lake, BC • Round Lake Treatment Centre-Armstrong, BC • Northwind Healing Centre-Dawson Creek, BC • Tsow-Tun Le Lum Treatment Centre-Lantzville, BC • Wilp Si’ Satxw House of Purifiaction-Kitwanga, BC

Brighter Futures/Building Healthy Communities- Brighter Future for First Nations and Inuit is a program for children and their families. It was established in 1992 for more infant and child oriented services for Canadians generally, and more mental health services for First Nations. Solvent abuse has been a particular focus on the brighter Futures/Healthy Communities Programs. Funds are distributed to bands according to formula, and used for community-based projects in five areas: • Healthy babies • Child development • Parenting skills development • Mental Health • Injury Prevention

Community Health Representatives (CHRs)- Community Health Representatives live and work in First Nations communities throughout Canada. They are usually First Nations people, who are hired by bands as health educators and advocates of healthy living. Traditionally, they have played important roles as intermediaries between FNIHB community health nurses and community members. They play a key role in health promotion, protection and injury prevention. They may provide a wide range of services such as: • Nutrition education and counselling • Maternal and infant care • Pre-school and school health education • Assistance to nurses in delivering the communicable disease program • Support and education for people with chronic health problems such as diabetes and heart disease • Support to elders • Keeping community health records • Taking water samples for Environmental Health Officer, etc.

Dental Health Services- The Non-Insured Health Benefits Program provides to Status Indians and Inuit peoples a range of medically necessary goods and services. One service provided is dental treatment services provided primarily by dentists in private practice who are then reimbursed by the program. Some First Nations are now developing their own options for community based dental care, including education, prevention and treatment. (Recently, the BC Medical Association has identified specific concerns with how FNIHB manages the NIHB program and they delayed the process of reimbursing the dentists. The Federal Minister of Health Canada has also expressed concern over the current situation and the FNIHB is now reviewing their dental care program. However, it is First Nation communities and individuals that are suffering because of an inability to pay the dentists up front and submit a reimbursement claim to FNIHB.)

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED FEB. 2003

HIV/AIDS On-Reserve Program- The purpose of this program is to provide information and prevention programs on HIV and AIDS to First Nation peoples living on reserve. It is a component of the National AIDS Program. Funding is limited and allocated on a project proposal basis. Examples of funded projects have included workshops in schools, band council and staff training, sexuality workshops, a candle light vigil for those who have died, and peer counselling training for youth.

Nursing Services-There are 104 Community Health Nurses working in the Pacific Region of FNIHB. They are all Registered Nurses, many with special training in community or outpost nursing. In non-isolated reserve communities, they deliver public health services and programs, work in Community Health Centres and travel to outlying communities as required. In isolated communities, they provide primary treatment services as well as public health programs, working in Nursing Stations where they are on call 24 hours a day.

Nurses in Community Health Centres and Stations are responsible for delivering mandatory immunization and communicable disease programs, as well as providing well baby clinics, home follow-up for conditions treated off-reserve, and a wide array of primary care, health promotion and disease prevention programs. These may include maternal health care, infant care, pre-schooler care, mental health counselling, chronic disease control and geriatric (elders) care. Nurses in isolated Nursing Stations, where there are no other medical services within 90 kilometres, are responsible for the diagnosis and treatment of illness as well as the public health programs listed above.

Nutrition- The Nutrition Education Program is delivered at the community level by nurses and community health representatives. Two nutritionists working part- time, under the supervision of a regional nutritionist support the program. The goal of this program is to encourage First Nation people to develop healthy eating habits, including the use of traditional native foods. Special attention is paid to the needs of the young, the elderly, and people with particular dietary requirements such as those suffering from diabetes.

Health Careers Program (“Meet the Challenge”)- The overall purpose of this program is to encourage and support Aboriginal people to enter the health professions and for a career in healthcare. A nation-wide bursary and scholarship program is administered from Ottawa.

Non-Insured Health Benefits

Aboriginal people have the same access as other citizens to medical services provided by the province of British Columbia such as physicians, hospitals, diagnostic testing and ambulance services. Where such services are lacking in remote reserves, they may be Health Canada First Nations and Inuit Health Branch may provide them. BC Medical Services Plan payments are made by Health FNIHB on behalf of those First Nations people who are eligible.

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED FEB. 2003

The health of First Nation peoples has for many years been below that of the general population. Federal fiduciary responsibility requires that Health Canada FNIHB provide a limited range of supplementary, non-insured health related products and services such as: • Transportation from remote and isolated areas to centres where needed services are available; • Prescription Drugs; • Medical supplies and equipment; • Comprehensive dental care; • Vision care, glasses and optical prosthetics; • Mental health crisis intervention services and some others.

Health Canada FNIHB incurs these costs as ‘payer of last resort’. Other insurers first cover costs. Provincial insurers such as Insurance Corporation of BC, Workers’ Compensation Board, the Ministry of Human Resources and Ministry of Children and Family Development, as well as private, third party insurers, must fulfil their obligation to First Nations clients as they do to other clients.

National Indian Health board accounts for over 80% of Health FNIHB annual expenditure. Pilot projects are currently underway to determine how the funding can be transferred to First Nations’ control. Four of these pilot projects are in British Columbia.

Disease Prevention and Control

FNIHB, Pacific Region, employs approximately 20 environmental health officers to help maintain public health on reserves. They are located at: Victoria, Nanaimo, Campbell River, Prince Rupert, Prince George, Williams Lake, Kamloops, Chilliwack, Salmon Arm, Kelowna, Merritt and Vancouver.

Their duties are to educate, advise on, inspect and monitor aspects of communities’ public health such as water quality, sewage treatment, waste disposal, housing quality, environmental contamination, and overall sanitation and safety in public buildings, recreational facilities and food preparation areas on reserves. Planning, development and remediation are done in close co- operation with bands.

The environmental health issue of greatest urgency in British Columbia reserves is water quality. First Nations suffer disproportionately from waterborne diseases such as Hepatitis A, Shigella, and Giardia. It was a recommendation of the Royal Commission on Aboriginal Peoples (1996) that basic standards of public health for drinking water and human waste disposal be met on all reserves within five years. Pacific Region is part of an on-going Indian and Northern Affairs Canada/ FNIHB to improve these services in First Nation Communities.

Capital Program

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED FEB. 2003 The purpose of the Capital Program is, over time, to provide a centre in all First Nation communities for the delivery of limited health programs and services. There are about 83 such facilities now, and there are many communities on the waiting list. Communities with no purpose built health centre may receive funding for rent.

Health Related programs Funded by Indian and Northern Affairs Canada • The Aboriginal Healing Fund (AHF) Program

The Royal Commission on Aboriginal People (RCAP) led to a federal position document called “Gathering Strength”. The Gathering Strength document recommended a reconciliation process to deal with the negative impact of the Residential School legacy. This led to the formation of the Aboriginal Healing Foundation. On January 7, 1998, the government of Canada announced that is was committing $350 million to the AHF to address the legacy of physical and sexual abuse in the Residential School system. This money will not be used as compensation to individuals or for the development of new structures or core funding for newly formed societies. It is to be used to support community healing initiatives for those who have suffered from the Residential School abuse or suffer from the Intergenerational Effects of Residential School. Projects will be designed and delivered by Aboriginal people at the local or regional level, and administered by an ‘arms length’ voluntary Board of Directors.

INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN REVISED FEB. 2003 APPENDIX S: PROPOSED 3 - YEAR OUTCOME TARGETS

The Ministry of Health Planning, in its feedback concerning the IH draft plan, asked that Interior Health set a small number of health outcome related targets to guide its Aboriginal health improvement activities. In considering appropriate targets, Interior Health reviewed the targets recommended by the Provincial Health Officer in the PHO 2001 Annual Report. At its December 2002 meeting, the IH AHWAC agreed that IH focus on four general target areas recommended in the PHO report: childhood immunization rates, early child developmental indicators, preventable hospital admissions, and community follow up after mental health hospitalization. Activities towards achieving the targets will be incorporated into the overall IH service plan submitted to the Ministry annually. Using the targets in the PHO report as the starting point, the following IH targets are proposed:

1. Sustain the currently high immunization rates among Aboriginal children so that the rates continue to be equal to or better than the non-Aboriginal children in IH.

Rationale: Available information indicates that Aboriginal children in Interior Health have high immunization rates (> 85%) equal to or greater than non- Aboriginal children living in IH. However, immunization data tracking currently are not consistent between IH and FNIHB. To better monitor and verify immunization rates, as well as sustain the current immunization coverage, will require formal information exchange protocols being established between service providers, with respect to immunization records. This target has the potential to leverage greater coordination in communicable disease control services in general, beyond immunization coverage.

2. Have in place by the fiscal year 2004-05 a set of measures for early childhood growth and development success.

Rationale: Early childhood development is identified in the draft plan as an ongoing issue requiring attention. Interior Health is embarking on a three year Early Child Development strategy, which will include strengthening our capacity to measure early childhood growth and development. This target provides a timely link between the Aboriginal Health and Wellness Plan and IH service redesign concerning child health services. This target is the same as the PHO recommendation.

3. A 5 % reduction in the average annual rate of preventable hospital admissions for selected chronic diseases, addictions, and mental health for the period 2003-04 to 2005-06, as compared to the baseline period of 1987-2000 used in the PHO report.

REVISION to the INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN FEB 14. 2003 Appendix S Page S - 1

Rationale: The PHO report as well as the IH draft plan identified the significantly higher rates of preventable hospital admissions for Aboriginal peoples compared to non-Aboriginal peoples. This is particularly true for chronic diseases, addictions and mental health. Chronic disease prevention and management is a major population health initiative of IH. Thus targeting this area can facilitate the integration of Aboriginal health concerns into a number of Interior Health service redesign processes.

The PHO report recommended a 25% reduction in preventable admissions by 2005. Preliminary analysis of the available data by Interior Health revealed that, the year-to-year variations in admissions can themselves be as high as 25%. The IH target is more modest and can be revised pending availability of additional data and further data analyses. Nevertheless, this target articulates Interior Health’s intent to work towards optimal health services utilization among Aboriginal populations. Further assessment of the nature of these preventable admissions is also key to effecting change. Additional targets with respect to hospital admissions and readmissions for selected chronic diseases will be considered, as we understand the challenges better. The table below shows data for 1997-98 to 2000-01, aggregated for Interior Health Status Indians population by year, gender, and age groups.

Preventable 1997-98 1998-99 1999-00 2000-01 Admissions f m f m f m f m Cases 17 21 18 16 11 22 16 21 Age 0-19 yrs Cases 73 54 70 81 70 53 55 49 Age 20-64 yrs Cases 10 8 13 7 11 6 7 7 Age 65+ yrs TOTAL 100 83 101 104 92 81 78 104

4. An annual 3% increase in the proportion of mental health admission having received appropriate community based follow-up after discharge.

Rationale: Data used for the PHO report and the IH draft plan show that Aboriginal mental health patients do not receive community follow up at the same rate as non-Aboriginal patients following discharge from hospital. Indeed, the Ministry of Health Planning in April 2002 allocated resources for Aboriginal Mental Health Liaisons across the province towards improving mental health service access and coordination for Aboriginal peoples. This target is the same as the PHO recommendation. To achieve this target will require collaboration between IH Mental Health and other Aboriginal Mental Health service providers. It should be noted that data issues, which may affect how this target is measured, exist with respect to the provincial Mental Health information system. This target will guide “directional changes” while data issues are addressed.

REVISION to the INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN FEB 14. 2003 Appendix S Page S - 2 APPENDIX T: LOGIC MODEL FOR THE INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN, WITH PROPOSED 3 - YEAR OUTCOME TARGETS

A LOGIC MODEL is a planning tool for summarizing linkages from program planning, to implementation, to outcome evaluation and target setting. Logic models are used by Health Canada for evaluating federally funded Aboriginal Health programs. The Logic Model for the Interior Health Aboriginal Health and Wellness Plan is presented below.

In summary, the IH Aboriginal Health and Wellness Plan identified 3 key priority areas where actions will be focused for the next 3 to 5 years:

1. Relationship building between IH and Aboriginal communities a. Cross culture awareness – IH staff b. Access to health services information by Aboriginal peoples c. Joint planning

2. Priority Aboriginal population needs a. Youth b. Elder c. People with mental illness

3. Decision support requirements a. Aboriginal specific health information b. Evidence based decisions / priorities

As the logic model shows, improvements in Aboriginal health and wellness will be achieved by concurrent activities in the 3 priority areas during the next 3 to 5 years. A key to success will be the incorporation of Aboriginal health concerns into Interior Health service redesign plans across the service continuum. As well, partnerships with other agencies that also deliver Aboriginal services will be vital.

The IH AHWAC considered the recommended targets contained in the Provincial Health Officer’s 2001 Annual Report for improving Aboriginal health. The committee chose four targets, with modifications, from the PHO recommendations. Rationale for the chosen targets is found in Appendix S.

REVISION to the INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN FEB. 2003 Appendix T Page S - 1 LOGIC MODEL (Part 1) - IH Aboriginal Health and Wellness Plan General Overview PRIORITY DECISION Priority Areas: RELATIONSHIPS POPULATIONS SUPPORT

Main Activities / 9 Strengthen the relationships 9 Assess the needs for three 9 Improve understanding of Inputs between IH and the Aboriginal populations: youth, elder, and Aboriginal health issues within peoples / communities through people with mental health illness Interior Health improvements in communication 9 Redesign Aboriginal youth, 9 Improve IH capacity to make links, culture awareness, information elder and mental health services evidence based decisions on provision, service coordination, and to be more culturally appropriate, Aboriginal health and health partcipation of Aboriginal people in and coordinated. service access. service planning and delivery. 9 Aboriginal participation in service redesign

Implementation 9 Improved relationships between 9 Resilient Aboriginal youths, 9 Better information base Objectives IH and Aboriginal communities ready to provide positive about the health of Aboriginal leading to improvements in contributions to community peoples within Interior Health Aboriginal access to timely, culturally 9 Culturally appropriate elder 9 Information to support targets appropriate health services care for improvements in appropriate 9 Partnerships between IH and 9 Improved mental health utilization other Aboriginal services providers among Aboriginal peoples leading to holistic approaches to health issues.

Outputs 9 Establish Health Service Area 9 Formal partnership between 9 Reliable database and level liaisons IH and MCFD Aboriginal surveillance system for 9 Conduct cross culture awareness Authority Aboriginal health status training for IH staff 9 Aboriginal components in IH 9 Report on Aboriginal health 9 Produce web page for Aboriginal Mental Health and Home & services utilization with health and directory of services for Community Care plans recommedations Aboriginal communities 9 Integrate Aboriginal health and health services needs into IH service redesign 9 Coordinate services with external agencies 9 Recruit Aboriginal people into IH

Short-term Outcome 9 Improved coordination of 9 Holistic, and culturally 9 Reductions in preventable Objectives services to Aboriginal people appropriate and coordinated hospital admissions. 9 Increase in use of appropriate services for the three priority 9 Increase in community follow services by Aboriginal people population groups: youth, elders, up afer mental health admissions and people with mental health 9 Child immunization rates illness equal or better than rates for IH non-Aboriginal children

Short-term Outcome 9 Level of trust between IH and the 9 Degree of collaboration 9 See long term targets below Indicators / Targets Aboriginal communities achieved between IH and MCFD 9 Degree of success in 9 Degree of Aboriginal participatio Aboriginal Authority improving Aboriginal health in IH health services planning 9 Degree of integration of information database 9 Degree of integration of Aboriginal health issues into IH Aboriginal health issues into IH MH and HCC service redesign service redesign planning plans 9 Degree of service coordination between IH and other Aboriginal services providers

Long-term Outcome Improved Aboriginal Health and Wellness Objectives

Long-term Outcome CHOSEN PRIORITY TARGETS: 1) Sustain child immunization rates at levels at least equal to Non- Indicators / Targets Aboriginal children within IH. 2) By 2005: have in place a set of early child development indicators. 3) By 2005: achieved a 5% reduction in preventable hospital admissions (provisional target). 4) An annual 3% increase in the number of Aboriginal mental health patients appropriately followed up after discharge from hospital. REVISION to the INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN FEB. 2003 Appendix T Page S - 2 LOGIC MODEL (Part 2) - IH Aboriginal Health and Wellness Plan Priority Area: Relationships Cross Culture Access to Health Key Issues Awareness - Services Information by Joint Planning IH staff Aboriginal Peoples

Inputs / 9 Establish formal communication 9 Develop an Aboriginal Health 9 Coordinate internal and Main Activities process between each HSA and section in IH web site. external actions on Aboriginal Aboriginal communities. 9 Develop a resource guide / Health issues. 9 Conduct workshops and service directory on health and 9 Recruit aboriginal people into orientations for Interior Health staff health services for Aboriginal health care on Aboriginal history and culture communities

Implementation 9 Regular communication between 9 Aboriginal people able to 9 Integrate Aboriginal issues Objectives IH and the Aboriginal communities access the right health services into IH planning proceses: 9 Service providers are aware of & health information in a timely population health, primary health the underlying determinants of and appropriate way. care, public health, chronic Aboriginal health issues disease, home & commuity care, 9 Aboriginal people able to access HR, mental health, addictions, the right health services & health acute care. information in a timely and 9 Increased inter-agency appropriate way coordination in services for Aborignal peoples(MCFD,FNIHB) 9 Increase in the number of Aboriginal HCWs in IH

Outputs 9 Workshops and orientation 9 Web site and directory 9 Inclusion of Aboriginal sessions for IH staff development / distribution component(s) into IH planning 9 HSA level liaison meetings documents and action plans. 9 Partnerships / protocols between IH and other agencies 9 Joint employment / training pgms with Aboriginal agencies / education institutions

Short-term Outcome 9 Change in Aboriginal culture 9 Increase in use of 9 Improved coordination of Objectives awareness among IH HCWs appropriate services by services to Aboriginal people 9 Aboriginal content in staff Aboriginal people 9 Increase in number of orientation material Aboriginal HCWs in IH 9 Increase in use of appropriate services by Aboriginal people

Short-term Outcome 9 Aboriginal liaison in place in 9 Webpage developed by 9 Number of IH planning Indicators / Targets every HSA by March 31, 2003 September 2003. documents with Aboriginal 9 Annual number of IH HCWs 9 Resource Guide / Directory component in place trained / oriented developed by March 2004 9 Number of inter-agency 9 Increased level of satisfaction 9 Increased level of agreements reached among Aboriginal peoples using IH awareness among Aboriginal 9 Formal partership achieved services peoples of services available with MCFD Aborginal Authority in 9 Increased level of 2003 satisfaction among Aboriginal 9 Percent of IH work force with peoples using IH services Aboriginal heritage

Long-term Outcome Improved Aboriginal Health and Wellness Objectives

Long-term Outcome CHOSEN PRIORITY TARGETS: 1) Sustain child immunization rates at levels at least equal to Non- Indicators / Targets Aboriginal children within IH. 2) By 2005: have in place a set of early child development indicators. 3) By 2005: achieved a 5% reduction in preventable hospital admissions (provisional target). 4) An annual 3% increase in the number of Aboriginal mental health patients appropriately followed up after discharge from hospital.

REVISION to the INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN FEB. 2003 Appendix T Page S - 3 LOGIC MODEL (Part 3) - IH Aboriginal Health and Wellness Plan Priority Area: Priority Populations

Key Issues Youth Elder Mental Health

Main Activities / 9 Conduct assessment on 9 Compile report on Aboriginal 9 Involve Aboriginal Inputs Aboriginal youth health needs. elder care needs based on existing communities in IH mental 9 Engage in partnerships with other assessments. health and addictions agencies delivering services to 9 Engage in partnerships with other services planning Aboriginal youths (MCFD, FNIHB, agencies delivering services to School Districts, Ministry of Aboriginal elders (eg FNIHB, Education) Aboriginal health services 9 Redesign health services to organizations) Aboriginal youths based on needs assessment

Implementation 9 Culturally appropriate and 9 Culturally appropriate and 9 Maximize successful Objectives coordinated health services for coordinated health services for mental health and addictions Aboriginal youths Aboriginal elders programs for Aboriginal 9 Resilient Aboriginal youths, ready people to provide positive contributions to community

Outputs 9 Needs assessment with report 9 Partnerships / service protocols 9 Aboriginal communities 9 Partnerships / service proocols between IH and other agencies involved in mental health and between IH and other agencies 9 Report on Elder needs and addictions planning through 9 Implementation of needs service gaps IH Aboriginal Health and assesment recommendations. Wellness Advisory Committee and Aboriginal MH Liaisons

Short-term Outcome 9 Aboriginal youth health services 9 Services to Aboriginal elders 9 An Aboriginal Mental Objectives based on needs assessment enhanced based on needs / gaps Health component 9 Increased coorindation of identified incorporated in the IH MH services between IH and other Plan agencies 9 An Aboriginal Addictions component incorporated in IH Addictions Plan

Short-term Outcome 9 Completion of Aboriginal youth 9 Completion of report on 9 Completion of IH Mental Indicators / Targets health needs assessment in 2003-04 Aboriginal elders care needs in Health and Addictions 9 Formal partership achieved with 2003-04 Services Plans with MCFD Aborginal Authority in 2003 9 Inclusion of Aboriginal elder Aboriginal components in needs in IH Home and Community 2003-04 Care redesign planning process

Long-term Outcome Improved Aboriginal Health and Wellness Objectives

Long-term Outcome CHOSEN PRIORITY TARGETS: 1) Sustain child immunization rates at levels at least equal to Non- Indicators / Targets Aboriginal children within IH. 2) By 2005: have in place a set of early child development indicators. 3) By 2005: achieved a 5% reduction in preventable hospital admissions (provisional target). 4) An annual 3% increase in the number of Aboriginal mental health patients appropriately followed up after discharge from hospital.

REVISION to the INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN FEB. 2003 Appendix T Page S - 4 LOGIC MODEL (Part 4) - IH Aboriginal Health and Wellness Plan Priority Area: Decision Support

Aboriginal Specific Evidence Based Key Issues Health Information Decisions / Priorities

Main Activities / 9 Create better information base 9 Detailed analyses of health service Inputs about the health of Aboriginal utilization by and health status of Aboriginal peoples within Interior Health (in peoples within Interior Health association with the Ministries of Health Planning and Health Services

Implementation 9 Improved information about the 9 Decisions support for actions towards Objectives health of Aboriginal peoples within service utilization / health outcome targets. Interior Health 9 Improved information about the health of 9 Improved understanding of Aboriginal peoples within Interior Health Aboriginal health issues within 9 Improved understanding of Aboriginal Interior Health health issues within Interior Health

Outputs 9 Reliable database and 9 Report on Aboriginal health services surveillance system for Aboriginal utilization with recommedations health status and service utilization 9 Early childhood developmental indicators in place

Short-term Outcome 9 Report on Aboriginal Health with 9 Implement strategies to enhance Objectives improved data, and with focus on appropriate service utilization based on early child development analyses, with focus on reductions in preventable hospital admissions, increased mental health follow up after hospitalization, and sustained child immunization rates

Short-term Outcome 9 Report on Aboriginal Health for 9 Reductions in preventable hospital Indicators / Targets IH completed in 2004-05 admissions as per PHO 2001 Annual Report 9 Increase in community follow up afer mental health admissions 9 Child immunization rates equal or better than rates for IH non-Aboriginal children

Long-term Outcome Improved Aboriginal Health and Wellness Objectives

Long-term Outcome CHOSEN PRIORITY TARGETS: 1) Sustain child immunization rates at levels at least equal to Non- Indicators / Targets Aboriginal children within IH. 2) By 2005: have in place a set of early child development indicators. 3) By 2005: achieved a 5% reduction in preventable hospital admissions (provisional target). 4) An annual 3% increase in the number of Aboriginal mental health patients appropriately followed up after discharge from hospital.

REVISION to the INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN FEB. 2003 Appendix T Page S - 5 APPENDIX U: ACCOUNTABILITY MAP - LINKING INTERIOR HEALTH OPERATIONS TO THE IH ABORIGINAL HEALTH AND WELLNESS PLAN

Every part of Interior Health will contribute towards the successful implementation of the IH Aboriginal Health and Wellness Plan. The table is a map of the links between IH operations and the plan’s recommended actions. The identified tasks will be integrated into each service area’s’ service redesign planning during the 2003-04 fiscal year.

Liaison / Immunization Early Childhood Enhance Aboriginal Youth Elder Care Improve Reduce Mental Relationships targets / Developmental Aboriginal Health web needs needs Aboriginal Preventable Health / Linkages / Communicable Success Employment page / service assessment assessment / Health Admissions Planning Understanding Disease Control Indicators in IH directories / services services Information

Health Service Areas ♫ ♫ ♫ ♫ ♫ Public Health ♫ ♫ ♫ ♫ ♫

Primary Health Care ♫ ♫ ♫ ♫

Mental Health ♫ ♫ ♫ Home and Community Care ♫ ♫

Acute Care ♫ ♫

Human Resource ♫ ♫

Media Relations ♫ ♫ Population Health Initiative ♫ ♫ ♫ ♫ Strategic Information ♫ ♫ ♫ Quality Council ♫ ♫ ♫

Starting in Dec 2003, and over the 2003-04 fiscal year, each IH service area identified in the above table will be invited to meet with the IH Aboriginal Health and Wellness Advisory Committee and collaboratively integrate the goals of the Aboriginal Health and Wellness Plan into IH operations.

REVISION to the INTERIOR HEALTH ABORIGINAL HEALTH AND WELLNESS PLAN FEB. 2003 Appendix U Page U - 1