EXECUTIVE SUMMARY 1 FEBRUARY 14, 2019 This summary report ‘Implementing Jordan’s Principle Service Coordination in the Alberta Region’ describes the development of the Enhanced Service Coordination initiative by the First Nations Health Consortium (FNHC) in Alberta. It is a result of a partnership between the FNHC, the McGill University Centre for Research on Children and Families, and researchers at McGill, the University of Montreal, and the University of Victoria. Funded through the Jordan’s Principle Child First Initiative, the FNHC’s Enhanced Service Coordination Model is in- tended to ensure that First Nations children in Alberta have more equitable and timely access to needed services. This report describes the formation of the FNHC and the development, implementation, and provision of a province-wide Enhanced Service Coordination Model from December 2016 to August 2018. The FNHC continues its efforts to im- prove service access for First Nations children and continues to address several of the key challenges outlined in this report. The FNHC continues developing strong provincial and national relationships and partnerships that are needed to ensure First Nations children in the Alberta region have equitable access to needed services. Our research team is con- tinuing its work in partnership with the FNHC and a follow up report will be available later in 2019. VANDNA SINHA LUNA VIVES ALISON GERLACH EXECUTIVE SUMMARY 1 THE CHILDREN’S SERVICES POLICY RESEARCH GROUP RESEARCH TEAM MEMBERS: Vandna Sinha Associate Professor, School of Social Work, McGill University. Luna Vives Assistant Professor, Département de Géographie, Université de Montréal. Alison Gerlach Assistant Professor, School of Child and Youth Care, University of Victoria. Kathryn Chadwick Research Assistant, Centre for Research on Child and Families, McGill University. Tyson Kelsall Research Assistant, Centre for Research on Child and Families, McGill University. Portia Larlee Research Assistant, Centre for Research on Child and Families, McGill University. Roberto Nieto Research Assistant, Département de Géographie, Université de Montréal. Meghan Sangster Research Assistant, Centre for Research on Child and Families, McGill University. CARTOGRAPHER: Roberto Amado Cartographer, Département de Géographie, Université de Montréal. REPORT COMPLETED IN COLLABORATION WITH THE FIRST NATION HEALTH CONSORTIUM. Copies of this report can be downloaded from: http://www.abfnhc.com/index.php/news Recommended citation: Sinha, V., Vives, L. and Gerlach, A. (eds.) (2018) Implementing Jordan’s Principle Service Coordination in the Alberta Region: The First Nations Health Consortium. Calgary/Edmonton, AB: The First Nations Health Consortium. Image credit: To dream the bear: Family, by Jason Carter. Used with permission from the artist. 2 EXECUTIVE SUMMARY CONTENTS Acknowledgements 5 Acronyms and Abbreviations 6 Executive Summary 8 Research Collaboration 9 Summary of Findings 10 Chapter 1: The Evolution of Jordan’s Principle 10 Chapter 2: The Implementation of Jordan’s Principle in Alberta: The First Nations Health Consortium 10 Chapter 3: The Enhanced Service Coordination Model 10 The Enhanced Service Coordination model in numbers 11 Continuing Challenges 12 Recommendations 13 Chapter 1 The Evolution of Jordan’s Principle 17 The Colonial Context of Services for First Nations Children: Discrimination in the Provision of Public Services 17 The Long Struggle to Realize Jordan’s Principle in Canada 18 Government Inaction and Failed Commitments: 2007-2016 19 Transformation in the Face of Government Resistance: The Canadian Human Rights Tribunal’s Decisions, 2016-2018 21 Eligibility 25 Range of Services 25 Timelines 25 “Substantive Equality” 25 The Short-Term Response to Implement Jordan’s Principle: Context for the Development of the First Nations Health Consortium in the Alberta Region 27 Under Pressure: Short Timelines and Unclear Guidance 28 Governing from a Distance: Canada Remains a Gatekeeper to Funding 28 A Moving Target: Changes in Eligibility Criteria 28 Launching in a Crowded Space: Overlapping National Initiatives 29 The Long-Term Response to Jordan’s Principle: A Fragmented National Policy Context 29 Chapter 2 The Implementation of Jordan’s Principle in the Alberta Region: The First Nations Health Consortium 39 The First Nations Health Consortium in the Alberta Region: An Introduction 39 The Colonial Context of Services for First Nations People in the Alberta Region 41 The Contemporary Context of Services 42 A Vision for First Nations Children 43 Establishing Organizational Capacity: A Race to Embody the Vision 43 EXECUTIVE SUMMARY 3 The Complex Regional Context: Multilateral Governance of Services for First Nations Children 45 The Assembly of Treaty Chiefs 45 Health Co-Management 45 Indigenous Services Canada (Alberta Region) 45 The Government of Alberta 46 Navigating Regional Expectations 46 Collaborating in a Divided Context: Regional Tensions and Expectations 46 Overlapping Roles and Lost Opportunities for Collaboration 47 Overcoming Challenges in Regional Relationships: (Re)Building and Collaboration 50 Ongoing Challenges: The Need to Reconcile Overlapping Mandates 52 Chapter 3 The Enhanced Service Coordination Model in the Alberta Region 59 Introduction 59 Evolution of the Enhanced Service Coordination Model 59 Model Development 60 First Nations Health Consortium Skills and Training 60 Outreach Activities 61 Growing Caseloads 63 Meeting Families Where They’re at: The Enhanced Service Coordination Model in Practice 63 Identification of Needs 64 Engaging and Collaborating with Families, Service Providers, Existing Programs, and Focal Points 67 The Clients: Supporting Families and Caregivers 67 The Focal Point: Collaborating with the Federal Government 68 Community Contacts and Service Providers 69 Follow up and Transition to Other Programs 71 Continuing Challenges: Focal Point Processes 72 Conclusion and Recommendations 78 Appendix 1: First Nations Health Consortium Interim Report Methodology 83 4 EXECUTIVE SUMMARY LIST OF TEXTBOXES, FIGURES, MAPS, AND TABLES Textbox 1: What is Jordan’s Principle? Textbox 2: Jordan River Anderson (1999–2005) Textbox 3: Summary of Pictou Landing Band Council and Maurina Beadle v. Canada Textbox 4: Questions for Assessing Substantive Equality Figure 1: The Research Collaboration between the Children’s Policy Research Group and the First Nations Health Consortium (2017–2019) Figure 2: The Enhanced Service Coordination Model in Numbers Figure 3: Continuing Challenges Figure 4: Jordan’s Principle Timeline (2016–2018) Figure 5: Timeline for Health Co-Management Funding Proposal (November 2016 to March 2017) Figure 6: The Iceberg: A Phased Approach Figure 7: The First Nations Health Consortium Logo Figure 8: Key Governance and Political Involvement in Health, Education, and Social Service Delivery in Alberta. Figure 9: Summary of Enhanced Service Coordination Model (October 2017) Figure 10: Number of Intakes by Month (October 2017 to May 2018) Figure 11: Unmet Needs Identified in Collaboration with Families and Service Providers (October 2017–May 2018) Figure 12: Jordan’s Principle Access Workers and Regional Service Coordinators Collaborate to Coordinate Health, Social, and Education Services for Children Figure 13: Focal Point Requirements Figure 14: Indigenous Services Canada Alberta Region Process Challenges Map 1: First Nations in Alberta Map 2: Outreach Efforts by the First Nations Health Consortium (October 2017 to May 2018) Table 1: 2018–19 Jordan’s Principle Group Requests in Alberta Table 2: Primary Data Collection: Types of Data, Data Sources, and Types of Information Collected FAMILY STORIES A Family’s Story (1): Palliative Care and Partial Approvals A Family’s Story (2): Waiting for a Safe Home A Family’s Story (3): Relocating from a Northern Community for Cancer Treatment A Family’s Story (4): Waiting for Denial ACKNOWLEDGEMENTS We want to thank members of the First Nations Health Consortium board and staff for their trust and support during the preparation of this report. This report is dedicated to all the individuals, families, and organizations from the national to the community level who are working to meet the needs of First Nations children and realize systemic changes in a discriminatory framework of public services. Motivated by love for their children, and inspired by the example of Jordan River Anderson’s family and the leadership of the First Nations Child and Family Caring Society, they are guiding the way to a more just society. EXECUTIVE SUMMARY 5 ACRONYMS AND ABBREVIATIONS AFN Assembly of First Nations. A national advocacy organization representing First Nation citizens in Canada, including more than 900,000 people living in 634 First Nation communities and in cities and towns across the country. AOTC Assembly of Treaty Chiefs of Alberta. An Alberta regional body that exercises political leadership on behalf of Alberta First Nations. AT Action Table (or Jordan’s Principle Action Table). A national-level table guiding policy development related to Jordan’s Principle. AWs Access workers (or Jordan’s Principle Access Workers). Frontline intake workers for the First Nations Health Consortium. CFI The Jordan’s Principle Child First Initiative Fund. This is the federal governement’s three-year, short-term response to Jordan’s Principle. CHRT Canadian Human Rights Tribunal. A national tribunal presiding over the application of the Canada Human Rights Act. CSPRG Children’s Services Policy Research Group. The group