North East LHIN Aboriginal Health Care
Reconciliation Action Plan
Anishinaabe Mno-nmaadziwin Ngodowendiiwin Teg
Maamwiz-dooying lw Enaaknegying
ᑭᐧᐁᑎᓄᐠ ᐃᑕᐧᐃᓂᐠ ᒥᓄᐱᒪᑎᓯᐧᐃᐣ ᑲᒪᒧᐧᐃ ᐊᑐᐢᑲᒋᑲᑌᐠ ᐃᓂᓂᐧᐃ ᑭᑎᒪᑫᓂᒋᑫᐧᐃ
ᐳᓀᓂᒥᑐᐧᐃᐊᑐᐢᑫᐧᐃᐣ ᐁ ᐅᓇᐢᑕᓂᐧᐊᐠ
Plan daksyon d’rékonsiliasyon d’RLISS du Nord-Est
Sèrvis dsanté Autochtone
September 2016
Gloria Antoine of Zhiibaahaasing First Nation with her
grandchildren Sage and Emily attended the Three Fires
Confederacy at M’Chigeeng First Nation on Manitoulin Island
where the North East LHIN staffed a booth to gather input on
how to strengthen health care for Aboriginal Northerners.
Manitoulin Island is home to 12,600 people, including seven
First Nation communities. Every year, the North East LHIN
provides about $24 million to deliver front-line health care on
Manitoulin Island.
Aboriginal Health Care Reconciliation Action Plan | 2
Table of Contents
Acknowledgements ............................................................................................................................ 4
Message from the LAHC Chair and NE LHIN CEO .............................................................................. 5
The History of Aboriginal People ....................................................................................................... 6
The Northeastern Ontario Landscape ............................................................................................... 7
NE LHIN and Aboriginal Health Care .................................................................................................. 8
NE LHIN-Funded Aboriginal Health Service Providers ....................................................................... 9
Our Reconciliation Plan Journey ..................................................................................................... 10
Our Vision for Reconciliation .......................................................................................................... 12
Our Reconciliation Plan Values ....................................................................................................... 13
Strategic Directions .......................................................................................................................... 14
Conclusion ........................................................................................................................................ 21
Appendices ....................................................................................................................................... 22
Note: Within this plan, the term “Aboriginal” refers to people who self-identify as First Nation, Métis,
Inuit, Indigenous.
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Acknowledgements
The North East Local Health Integration Network (NE LHIN) would like to thank
the individuals who participated in engagements that informed the development
of this North East LHIN Aboriginal Health Care Reconciliation Action Plan. In
addition, Helen Bobiwash and members of the 2015-2016 LHIN’s Local Aboriginal
Health Committee (LAHC) were instrumental in putting this plan together. See list
of members below.

Gloria Daybutch (Chair), Executive Director, Maamwesying North Shore Community Health
Services Inc., Cutler

Dawn Madahbee, NE LHIN Board Director, and General Manager of Waubetek Business
Development Corporation

Dale Copegog, Director of Health and Social Service, Wasauksing First Nation, Parry Sound

Rachel Cull, Executive Director, Misiway Milopemahtesewin Community Health Centre, Timmins

Sally Dokis, Health Director, Dokis Health Centre, Monetville

Giselle Kataquapit, Health Director, Peetabeck Health Centre, Fort Albany

Julie Morin, Operational Director, Mnaamodzawin Health Centre, Little Current

Veronica Nicholson, Executive Director, Timmins Native Friendship Centre, Timmins

Angela Recollet, Executive Director, Shkagamik-Kwe Health Centre, Sudbury

Janice Soltys, Chief Information Officer, WAHA, James and Hudson Bay

Tyler Twarowski, Program Manager, CMHA Cochrane Timiskaming Branch, Timiskaming

Mary Jo Wabano, Health Services Director, Wikwemikong Health Centre, Manitoulin Island

Pam Williamson, Executive Director, Noojmowin-Teg Health Centre, Little Current

Louise Paquette, NE LHIN Chief Executive Officer

Cynthia Stables, NE LHIN Senior Director, Cultural Diversity, Community Engagement,
Communications

Natalie Atkinson, NE LHIN Aboriginal Lead

Katerine Moyer, NE LHIN Project Coordinator
Aboriginal Health Care Reconciliation Action Plan | 4
Dear Fellow Northerners,
Aanii Giiwednong Endnaakiiyek Nwiijkiwedik,
ᑭᓇᐧᐊᐤ ᐣᑐᑌᒪᐠ ᑭᐧᐁᑎᓂᐧᐃᓂᓂᐧᐊᐠ
Chèr konpagnyon d’Nord
On behalf of the North East LHIN and the North East Local Aboriginal Health Committee (LAHC), we are pleased to share
our North East LHIN Aboriginal Health Care Reconciliation Action Plan. We developed this plan together. The outcomes
of LHIN-led engagements with Aboriginal Northerners over the past several years have greatly informed this plan.
The plan encompasses four main strategic directions -- Opportunities (East); Relationships
(South); Knowledge and Understanding (West); and Sustainability and Evaluation (North).
The plan will be implemented using the Medicine Wheel as a guide – a widely recognized
approach that represents wholeness, balance and interconnectedness. Each strategic
direction plays an integral role in the success of this plan.
Historically, Aboriginal people in Canada had strong, independent and thriving societies.
They welcomed and created partnerships enabling newcomers to survive and establish a
permanent home here. The federal government used colonial policies and residential
schools to systematically eradicate their distinct social, cultural, legal and spiritual
practices. The health status of Aboriginal people in Ontario is a direct result of the colonial
harm and generational trauma this has caused in the lives of Aboriginal peoples. It is our
moral duty to work with Aboriginal people in Northeastern Ontario to walk the journey of
reconciliation and work toward closing the gaps in health outcomes between Aboriginal and
non-Aboriginal communities.
We recognize that understanding the historical, contemporary and cultural factors that
have an impact on Aboriginal people is key to understanding their current health status
and their need for culturally appropriate health care services. Building on a foundation
that is inclusive and respectful of Aboriginal culture and history, this plan begins a
process for change that will help to address the health disparities of the Aboriginal
population within Northeastern Ontario.
Louise Paquette, NE LHIN
Chief Executive Officer
Gloria Daybutch, Chair,
NE LHIN Local Aboriginal
Health Committee
The North East LHIN will incorporate this plan in its efforts to work towards cultural proficiency across the region and
increase the health and wellness of Aboriginal people. We will continue to foster relationships with partners and
organizations, sharing our goals and priorities, and will measure our efforts in our path towards success. If your
organization would like to work with us to accomplish these goals, we welcome hearing from you.
This plan reinforces our commitment to improving health services for Aboriginal people living in Northeastern Ontario
and to achieving greater health equity. Together, we are building a stronger system of care that will benefit all
Northerners today and for generations to come.
Yours in health and wellness,
Kaa-ne Naaghadoonaa Waa-shi Mno-maadzying
Miinwaa Wii-Mnomaajiishkaaying,
ᓂᓇ ᒥᓄᐱᒪᑎᓯᐧᐃ ᐊᑐᐢᑫᐧᐃᐣ ᑲ ᐊᑐᐢᑲᑕᐠ
Bin a vou, santé é biyenèt
Louise Paquette
Gloria Daybutch
Chief Executive Officer
North East Local Health Integration Network (NE LHIN)
Chair, NE LHIN Local Aboriginal
Health Committee
Aboriginal Health Care Reconciliation Action Plan | 5
The History of Aboriginal People
Aboriginal people are the original inhabitants of North America. The Canadian Constitution recognizes
three groups of Aboriginal people — First Nation (Status and Non-Status Indians), Métis and Inuit. Each
group has unique heritage, language, cultural practices and spiritual beliefs.
The history of Aboriginal people in Canada is rich and diverse and reaches back before the arrival of
Europeans. Aboriginal people had thriving societies with flourishing intertribal trade, and a sustainable
approach towards the use of lands and resources. The history of First Nations, Inuit and Métis is
important in the development, and future, of Canada, Ontario and Northeastern Ontario.
Aboriginal people welcomed newcomers to this land and forged partnerships to help them survive and
build a home in a harsh, unknown environment. The British Crown recognized the original occupancy of
Aboriginal people in Canada with the Royal Proclamation in 1763. Treaties were negotiated and signed
to create mutual benefits for the Aboriginal people and newcomers.
By 1867, the year of Canadian Confederation, the federal government implemented policies and
enacted the Indian Act to assimilate Aboriginal people into the colonial society. Aboriginal people were
isolated to reserves, whole communities were relocated, and Aboriginal cultural practices were
outlawed. Many colonial policies continue today.
Children were forced into residential schools and taken from their families and communities for
adoption. Families were fractured. Children experienced mental, physical and sexual abuse. There
were more than 130 residential schools in Canada. The last one closed in 1996. Six of the 18 residential
schools that operated in Ontario were located in Northeastern Ontario. The trauma of the residential
schools and the adoption policies are still felt today by Aboriginal people.
Despite the efforts of the federal government to eradicate Aboriginal culture and societies, Aboriginal
people have survived. However, many policies have left scars on generations as is evidenced in today’s
physical and mental health issues, addiction and substance abuse, violence and high rates of suicide
amongst Aboriginal people. Gaps exist between Aboriginal and non-Aboriginal populations with respect
to health, levels of education attainment, and over-representation among homeless and prison
populations.
In December 2015, Canada’s Truth and Reconciliation Commission (TRC) released its report on what it
heard with respect to the residential schools in Canada. The TRC called for reconciliation to address the
ongoing legacy of colonialism and the creation of a more equitable and inclusive society by closing gaps
in health and other areas.
In May 2016, the Ontario government apologized for the history of colonial policies that disempowered
Aboriginal Ontarians and released Ontario’s First Nations Health Action Plan.
The NE LHIN acknowledges the impact of colonial federal policies on the Aboriginal people residing
within Northeastern Ontario and aims to close the gaps in health through this Aboriginal Health Care
Reconciliation Action Plan.
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The Northeastern Ontario Landscape
Aboriginal Population within the Region
 About 60,000 Aboriginal people, approximately 11% of the total population
o 39 First Nations; 9 Métis Nation communities; 7 Aboriginal Friendship Centres
 Within this Aboriginal population:
o 62% are First Nation; 37% are Métis; 41% are 24 years of age and younger; 34% are 45 years
of age or older
Health Conditions
In general, Aboriginal people experience a lower health status than other Northerners. The primary health conditions
experienced by Aboriginal Northerners, includes:
 Higher rates of medically complex chronic health conditions such as diabetes, hypertension and mental health disorders.
 Physical aging at a younger age due to multiple chronic conditions.
 Higher cases amongst Aboriginal youth of mental health issues, chronic illnesses and poor oral health.
 High rates of suicide and suicide ideation.
 First Nations people are over-represented as clients in addiction services across Northeastern Ontario.
Health and other Factors
In its 2016 reports Cancer in First Nations in Ontario and Cancer in the Métis People of Ontario, Cancer Care Ontario reports
that:
 More Aboriginal people smoke than the general population.
 The proportion of overweight or obese Aboriginal people is higher than the general population.
 Aboriginal Northerners are less likely to consume the recommended servings of fruit and vegetables.
 According to the National Household Survey (2011)
o The Aboriginal unemployment rate is approximately 4.4% higher than the total unemployment rate in the NE LHIN.
o 24% of private households in the NE LHIN deemed “not suitable” by the National Occupancy Standard
are Aboriginal households.
o 14% of Aboriginal people in the NE LHIN aged 15 years and older in private households are
unemployed.
Physical Environment
Peoples’ physical environment has an impact on their health outcomes. The 2011 National Household Survey,
Aboriginal Population Profiles reports that:
 One-fifth of private dwellings occupied by Aboriginal people require major repairs.
 There are high mobility rates among the Aboriginal population.
 Almost 30% of people in private Aboriginal households are living under the poverty line.
The Aboriginal Peoples Survey, 2012, reports that 18% of Aboriginal people, aged 6 years and older who live off-reserve,
experience low or very low food security, (an indicator related to the supply of food, and individuals' access to it).
Aboriginal Health Care Structure
 Aboriginal people access a variety of health services through Aboriginal and mainstream providers that are
located on- and off-reserve.
 Funding for health services flows to health service providers from federal, provincial, LHIN and Aboriginal
Political Territorial Organizations. The wide range of funding levels between different jurisdictions often leads
to inequities in service levels, duplication or gaps in program support, and reporting pressures on health service
providers who must account to several levels of government for support received.
 Many urban health service providers offer services to all Aboriginal heritage groups.
Aboriginal Health Care Reconciliation Action Plan | 7
NE LHIN and Aboriginal Health Care
The NE LHIN is committed to improving the health of Aboriginal people across Northeastern Ontario – a
part of Ontario that spans 400,000 square kilometres. Over the past 10 years, the NE LHIN has engaged
with Aboriginal/First Nation/Métis leadership, communities and health service providers. The outcomes
of these engagements are reflected in the LHIN’s priorities in strengthening the system of care for people
living in Northeastern Ontario.
Since 2009, the NE LHIN has relied on the expertise of its Local Aboriginal Health Committee (LAHC) to guide
its work in better meeting the health care needs of people who identify as Aboriginal, First Nation or Métis.
The LAHC is comprised of senior representatives of Aboriginal health care organizations across the
region. It advises the LHIN Board of Directors on health service priorities, opportunities for engagement,
and better coordination of services within Aboriginal/First Nations/Métis urban and rural communities.
Members travel hundreds of kilometres to meet face-to-face twice per year. In between, meetings are
held via teleconference as needed. Members represent the needs of people living within their
geographic area and not their individual organization.
The NE LHIN holds accountability agreements with 35 Aboriginal providers including:




One Hospital (Weeneebayko Area Health Authority - WAHA, James Bay Coast) – WAHA serves a
remote population of about 7,000 and the communities of Moose Factory, Moosonee,
Peawanuck, Kashechewan, Attawapiskat and Fort Albany. In addition to WAHA, this far northern
part of the LHIN is home to two federally-funded nursing stations (Kashechewan and Peawanuck).
One 59-bed Long-Term Care facility (Wikwemikong)
One Community Health Centre (Misiway, Timmins)
34 Community Support Service Providers, including three Aboriginal Health Access Centres (AHACs),
Six Mental Health and Addiction Providers, and others (see map on next page).
Note: Some organizations provide services in more than one sector and may be counted twice.
North East LHIN funded services delivered through 35 Aboriginal providers:
Hospital (WAHA) - $23.3M
Community Support Services - $8M
Community Health Centre - $2.3M
Mental Health & Addictions - $3.1M
Long-Term Care - $2.6M
Diabetes - $335,000
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NE LHIN-Funded Aboriginal Health Service Providers
Every year, the NE LHIN invests more than $39 million to deliver health care services to Aboriginal people
living in Northeastern Ontario.
To view a map of Aboriginal health service locations across the NE LHIN, including Métis Councils,
Federally-Funded Services, Aboriginal Friendship Centres, Public Health Units, Canadian Red Cross health
services, and Métis Health & Wellness Worker offices, see Appendix B.
Aboriginal Health Care Reconciliation Action Plan | 9
Our Reconciliation Plan Journey
The need for a Northeastern Ontario Aboriginal Health Care
Strategy and Reconciliation Plan was identified as a result of
engagements held with the LAHC, Aboriginal people and providers
within the LHIN catchment area, including:


Engagements held in five communities along the James and
Hudson Bay Coast to help inform actions needed to increase
access to care for people living in the LHIN’s most Northerly
communities. The LHIN team heard first-hand stories of a
system that is heavy with opposites – gaps/duplications of
service providers, an absence of checks/balances across the
system, new/aging equipment that often sits idle due to
untrained staff, and examples of both tragedy and triumph of
the human spirit.
43 public community engagement sessions and two online
surveys in 2015 to gather input from Northerners on the
LHIN’s 2016-2019 Integrated Health Service Plan (IHSP).
Our North East LHIN
Commitment
We will ensure the North East LHIN
Aboriginal Health Care
Reconciliation Action Plan is an
evolving document that will be
reviewed annually and updated
with new initiatives.
Over the course of the NE LHIN’s
current Integrated Health Service
Plan (2016-2019), our immediate
focus is on delivering high quality
outcomes through a focus on the
following strategic directions:




Opportunities
Relationships
Knowledge and Understanding
Sustainability and Evaluation

15 public engagement sessions and an online survey in
January/February 2016 to gather input and respond to the
Ministry of Health and Long-Term Care’s Patients First: A
Proposal to Strengthen Patient-Centred Health Care in Ontario.
This effort included two Aboriginal-specific engagements and a special meeting of LAHC.

Biannual meetings of the LAHC to discuss opportunities for increased access, coordination and
sustainability of health care services to the region’s Aboriginal population.
Over the years, engagements with Aboriginal Northerners have revealed several ways to strengthen
health care. These include providing mechanisms for cultural competency training with health service
providers, expanding the availability of traditional health programs and services, improving quality of
hospital care and coordination of services upon discharge, increasing mental health and addiction
services, and encouraging all levels of government to work more closely together to deliver quality health
services, to name a few. (Visit www.nelhin.on.ca to learn more about engagement outcomes.)
This plan was also informed by an analysis of an environmental scan (Appendix A). The scan was
completed using outcomes of engagements, available statistical data, and aggregate electronic medical
records data pertaining to the top health conditions of the Aboriginal Health Access Centres and
Aboriginal Community Health Centre within the region.
Aboriginal Health Care Reconciliation Action Plan | 10
Other recent events reinforce the importance of our Reconciliation Plan, including:

In December 2015, the Truth and Reconciliation Commission (TRC) released its report which includes
94 calls to action to aid in the reconciliation of the legacy of Canada’s residential school system.

In May 2016, the Premier of Ontario apologized for the history of colonial policies that disempowered
and disenfranchised the Indigenous peoples of Ontario and the continued harm this has caused to
Aboriginal cultures, communities, families and individuals.

Ontario’s First Nations Health Action Plan was announced in May 2016. It outlined significant
investments in Aboriginal health care in four key areas: primary care, public health and health
promotion, seniors’ care and hospital services, and life promotion and crisis support.
This North East LHIN Aboriginal Health Care Reconciliation Action Plan is informed by NE LHIN-led
engagements, the active involvement of LAHC, the Federal and Provincial government response to the
impact of residential schools on Aboriginal people, and the need for a collaborative effort to strengthen
the health care status of Aboriginal Canadians.
The process followed to complete this plan enabled the NE LHIN to focus on building stronger
relationships and raising awareness of fellow Northerners on the need for a shared understanding and
ownership of this plan today, and into the future.
“It is our vision to support
the healing process of our
communities in order for
our future generations to
never have to suffer from
uncontrolled poor health
and well-being”
– Gloria Daybutch, Chair, NE LHIN
Local Aboriginal Health
Committee
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Our Vision for Reconciliation
Aboriginal people living in Northeastern Ontario will enjoy a quality of
life and health status equal to all Ontarians from birth to end of life.
The NE LHIN and its Local Aboriginal Health Committee acknowledge
that:
 Aboriginal people have an equal right to attain the highest standard of health.
 The current state of Aboriginal health in Northeastern Ontario is a direct result
of previous Canadian government policies, including residential schools.
 Reconciliation means addressing inequities and closing the disparity gap of
Aboriginal health. It is important to educate Northern Ontarians about this
Reconciliation Plan and to distribute information that can be used within
Aboriginal communities.
 Improved health outcomes are based largely on the social determinants of
health and are grounded in Aboriginal practice that culture is treatment and
therapy.
To achieve our vision, we will:
 Value Aboriginal healing practices and advocate for increased understanding of
its importance so that those who request it can receive it.
 Support better access to health education resources for life-long learning and
increased self-care.
 Contribute to closing the gap in life expectancy that exists between Aboriginal
and other Northern Ontarians.
 Support a climate that ensures the patient remains at the centre of a shared
care model for Aboriginal people living in Northeastern Ontario.
 Recognize the impact of social, environmental and economic conditions on the
health and well-being of individuals.
 Work collaboratively with all levels of government, communities and health
service providers, for greater health equity for Aboriginal people living in
Northeastern Ontario.
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Our Reconciliation Plan Values
In keeping with the Seven Grandfather Teachings, the following seven values have been identified for our
North East LHIN Aboriginal Health Care Reconciliation Action Plan. Incorporating these values further
grounds our work in Aboriginal culture, keeping us mindful of the people the plan is serving.
Collaboration and Relationship Building (Love)
The teaching of love is required to build relationships and to give freely without conditions. Collaboration
and relationship building, between all levels of the health care system, will address jurisdictional barriers
that impact the health outcomes of Aboriginal people.
Reconciliation (Respect)
The teaching of respect is important in reconciliation as it teaches us to look at things in another way, beyond
what our eyes see. Reconciliation starts with an awareness of the past, acknowledgement of the harm inflicted
on Aboriginal people and action to develop and maintain a mutually respectful relationship. Reconciliation will
support Aboriginal people to heal and help to close the gaps in health outcomes.
Traditional Health and Healing (Bravery)
The teaching of bravery is about doing the right thing and standing up for our convictions even in the face
of adversity. Traditional health and healing is integral to improving Aboriginal population health
outcomes. It is important to facilitate access to Aboriginal healing practices for those who request it.
Diversity (Honesty)
The teaching of honesty is about walking this journey in an honest way and “walking the talk.” It is
important to “walk the talk” to address the health needs of Aboriginal communities in a way that respects
their distinct needs and recognizes their diversity. Special consideration and support must be given to
Coastal communities that are faced with great challenges related to their geographic isolation.
Shared Responsibility (Humility)
The teaching of humility teaches us everyone is equal -- not less than or more than. All involved in the
health care system, including the individual, Aboriginal health service providers, mainstream health
service providers and governments have a shared responsibility to work together to strengthen the
delivery of health care programs and services to Aboriginal people.
Health Equity (Truth)
The teaching of truth is about not deceiving ourselves or others -- to speak truth from the heart. It is vital
to reduce the health disparities between the Aboriginal population and the overall population in the
region. Measurable goals must be identified and reported on to close the gaps in health outcomes.
Cultural Competency (Wisdom)
The teaching of wisdom is about listening and gathering knowledge to be used for the good of the people.
It is important that all health service providers develop cultural competency to better understand the
history of Aboriginal peoples in Canada, and the legacy of residential schools and to learn approaches that
deliver health services in a culturally safe manner to the Aboriginal population.
Aboriginal Health Care Reconciliation Action Plan | 13
The Four Strategic Directions
The North East LHIN Aboriginal Health Care Reconciliation Action Plan encompasses four strategic
directions. The Medicine Wheel is divided into quadrants often used to signify the four directions,
seasons, life cycles, etc. It is a widely recognized symbol of balance, interconnectedness and the
Aboriginal holistic world view of thinking. Borrowing from these teachings, the four strategic directions of
the NE LHIN have been placed on the medicine wheel are:
Starting in the East, Opportunities – The East is our gift of vision. Creating and identifying opportunities
for new or enhanced initiatives will help us succeed in our vision of optimal health and well-being for
Aboriginal people.
Moving to the South, Relationships – The South is our gift of time. Building relationships and
collaboration takes time, but investing in this time can result in positive healthy outcomes for present and
future generations.
Moving to the West, Knowledge and Understanding – The West is our gift of knowledge and feeling. As
more people learn about the true history of Aboriginal people and its impact on their health, it will create
empathy and understanding which will help to create safe health service delivery environments.
Moving to the North, Sustainability and Evaluation – Sustainability and progress of the plan will be
achieved through evaluation and the plan will be updated to reflect the current needs. The desired
outcome of health and well-being for Aboriginal people will be moved in a positive direction.
Sustainability and Evaluation
(North)
Knowledge and
Understanding
(West)
Opportunities
(East)
Relationships
(South)
Aboriginal Health Care Reconciliation Action Plan | 14
Strategic Direction – Eastern Door:
Opportunities
GOAL: Increase access to services and close gaps in care to achieve better health
outcomes for Aboriginal people living in Northeastern Ontario.
Action
Timeline
Alignment
Measurable Target
1
Educate health service
providers on the value of
Aboriginal healing practices
and correspond with LHINfunded health service
providers (HSPs) to ask that
they accommodate the use
of traditional healing for
those who request it.
 September 2017
 LHIN IHSP 2016-2019
 LHIN Annual Business
Plan
 TRC Calls to Action
 Ontario’s First Nations
Health Action Plan
 Number of HSPs
contacted and
committed to making
accommodations for
traditional healing
2
Identify the gaps in
diabetes services within
Aboriginal communities
and develop a strategy to
aid in closing the gaps.
 March 2018
 LHIN IHSP 2016-2019
 LHIN Annual Business
Plan
 Ontario’s First Nations
Health Action Plan
 Report on gaps
 Develop strategy
3
Collaborate with all levels
of government that fund
diabetes services to align
programs, reduce
duplications and address
gaps.
 March 2019
 LHIN IHSP 2016-2019
 LHIN Annual Business
Plan
 TRC Calls to Action
 Ontario’s First Nations
Health Action Plan
 Number of meetings
with partners who fund
diabetes programs and
services
 Meeting outcomes/
deliverables
4
Engage with the Ministry of  Ongoing
Children and Youth
Services to explore
strategies to address gaps
in services for Aboriginal
children and youth, such as
mental health services.
 LHIN IHSP 2016-2019
 LHIN Annual Business
Plan
 Ontario’s First Nations
Health Action Plan
 Journeying Together:
Ontario’s Commitment
to Reconciliation with
Indigenous Peoples.
 Regular Meetings
 Meeting outcomes/
deliverables
Aboriginal Health Care Reconciliation Action Plan | 15
Action
Timeline
Alignment
Measurable Target
5
Evaluate opportunities to
transfer the delivery of
home and community care
services to Aboriginal
community-based
organizations.
 March 2018
 LHIN IHSP 2016-2019
 LHIN Annual Business
Plan
 Patients First: Action
Plan for Health Care
 Ontario’s First Nations
Health Action Plan
 Ongoing discussion
with Aboriginal
community-based
organizations who
provide home and
community care
services
6
Engage Aboriginal
Northerners in the
planning to strengthen
mental health and
addictions services for
Aboriginal people and work
through the NE LHIN’s
Mental Health and
Addiction Services
Collaborative to implement
an action plan to help
increase mental health and
addiction services for
Aboriginal Northerners.
 Ongoing
through to
September 2018
 TRC Calls to Action
 LHIN IHSP 2016-2019
 LHIN Annual Business
Plan
 Ontario’s First Nations
Health Action Plan
 Journey Together:
Ontario’s Commitment
to Reconciliation with
Indigenous Peoples
 Development of
Memorandums of
Understanding
between the NE LHIN
and health services
providers to increase
access to mental health
and addiction services
 Aboriginal
representation on the
North East Mental
Health and Addictions
Collaborative, including
a Co-Chair
7
Identify opportunities to
develop strategies for
better elders’ health. For
example, building on the
North East Specialized
Geriatric Centre
programming underway in
Coastal communities.
 Ongoing
 LHIN IHSP 2016-2019
 Ontario’s First Nations
Health Action Plan
 Patients First: Action
Plan for Health Care
 Development of a
strategy to address
geriatric needs of
Aboriginal seniors in
Northeastern Ontario
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Strategic Direction – Southern Door:
Relationships
Goal: Implement improvements across the health system that result in greater accessibility and
coordination of health services for Aboriginal people while strengthening relationships.
Action
Timeline
Alignment
Measurable Target
1
Facilitate quarterly meetings with the  Ongoing
provincial and federal governments
and health service providers to
explore strategies to address the
jurisdictional complexities.
2
Support increased access to
traditional healing programs.
3
Evaluate and assess the current status  By March 31,
of patient transitions of care between
2018
hospitals and community and identify
strategies at the NE LHIN sub-region
level to address the gaps.
 LHIN IHSP 2016-2019
 Needs assessment report
 LHIN Annual Business Plan  Strategy
 Ontario’s First Nations
 Improved coordination of care
Health Action Plan
for Aboriginal patients upon
hospital discharge
 Patients First: Action
Plan for Health Care
4
Work with the region’s five public
 By March 31,
health units and Health Canada to build
2017
opportunities and ensure the sharing of
best practices between Aboriginal
communities and the health units.
 Patients First: Action
Plan for Health Care
 Ontario’s First Nations
Health Action Plan
5
Ensure Aboriginal representation on
LHIN-led health system tables,
including NE LHIN sub-region work.
 Fall 2016 and
as required
 LHIN IHSP 2016-2019
 Increased Aboriginal
representation and
 LHIN Annual Business Plan
participation on LHIN-led
 TRC Calls to Action
planning tables
6
Ensure continued engagement of
Aboriginal patients and providers to
continue to improve health
care access and system coordination.
 By March 31,
2018
 LHIN IHSP 2016-2019
 Strategy in place to engage
health services providers in
 LHIN Annual Business Plan
system transformation
 Patients First: Action
 Number of Aboriginal patients
Plan for Health Care
and providers actually
engaged
 Ongoing
 LHIN IHSP 2016-2019
 Regular Meetings
 LHIN Annual Business Plan  Meeting outcomes/
deliverables which include an
 TRC Calls to Action
inventory of issues and a
common work plan




 Completion of an inventory of
LHIN IHSP 2016-2016
available traditional healing
LHIN Annual Business Plan
programs and an assessment
TRC Calls to Action
of gaps and opportunities
Ontario’s First Nations
 Increased availability of
Health Action Plan
traditional healing programs
 Invite a public health unit (PHU)
member to sit on LAHC
 Meet with region’s five PHUs
to establish a process to
strengthen access to PHU
programs/services by
Aboriginal Northerners
Aboriginal Health Care Reconciliation Action Plan | 17
Strategic Direction – Western Door:
Knowledge and Understanding
GOAL: Increase knowledge and understanding about Aboriginal people, their language,
culture, and history to create safe and respectful health care environments.
Action
Timeline
Alignment
Measurable Target
1
Develop an accountability
agreement with NE LHIN staff
to ensure commitment to
implementing the plan.
 December 2016
 LHIN IHSP 2016-2019
 TRC Calls to Action
 100% of LHIN staff with
signed accountability
agreements
2
Develop a work plan to
implement cultural
competency/safety training
to all LHIN staff, LHIN Board
members, and NE LHINfunded health service
providers.
 LHIN staff and
board training
by December
31, 2016
 HSP training by
March 31, 2018
 TRC Calls to Action
 LHIN IHSP 2016-2019
 LHIN Annual Business
Plan
 Ontario’s First
Nations Health Action
Plan
 Development of multiyear strategy to ensure
continued cultural safety
training
 Number of people who
participate in training
annually
3
Share this plan with Northern
post-secondary institutions as
a means of encouraging their
development of competency
training within their
curriculum and operations.
 By December
31, 2017
 TRC Calls to Action
 Ontario’s First
Nations Health Action
Plan (May 2016)
 Number of postsecondary institutions
engaged
 Post-secondary response
4
Encourage health service
providers to make their
physical environment more
welcoming to Aboriginal
people, for example: public
display of Aboriginal artwork,
translated way-signage and
promotional material, and a
public display through
signage of the Aboriginal
territory in which the HSP
building is located.
 Ongoing and by
March 31, 2018
 LHIN IHSP 2016-2019
 LHIN Annual Business
Plan
 TRC Call to Action
 Number of health service
providers who install
signage
 Public acknowledgement
of the offices that make
these efforts
Aboriginal Health Care Reconciliation Action Plan | 18
Action
Timeline
Alignment
Measurable Target
5
Undertake an evaluation of
cultural competency training
completed by health service
providers.
 March 2018
 LHIN IHSP 2016-2019
 LHIN Annual Business
Plan
 TRC Calls to Action
 Ontario’s First
Nations Health Action
Plan
 Completion of evaluation
measuring the changes
stemming from the
training
 Number of HSPs
participating in the
evaluation
6
Recommend HSPs add
Aboriginal representation on
their Board of Directors to
provide guidance on the
needs of Aboriginal people.
 March 31, 2017
and ongoing
 Patients First: Action
Plan for Health Care
 TRC Calls to Action
 Increase number of HSPs
with Aboriginal board
representation
7
Develop and implement
culturally appropriate
Personal Support Worker and
mental health training
programs.
 December 2017
 IHSP 2016-2019
 Patients First: Action
Plan for Health Care
 Ontario’s First
Nations Health
Action Plan
 Training program
developed
 Curriculum implemented
Health
Care Reconciliation
Action
AboriginalAboriginal
Health Care
Reconciliation
Action Plan
| 19 Plan | 19
Strategic Direction – Northern Door:
Sustainability and Evaluation
GOAL: A sustainable and measured health care system for Aboriginal people living in
Northeastern Ontario that includes ongoing evaluation of this plan and gains
made to improve the health outcomes of Aboriginal people.
Action
Timeline
Alignment
Measurable Target
1
The reconciliation plan is
included in NE LHIN decisionmaking criteria for the
evaluation of proposals and
new programs and services.
 Ongoing
 LHIN IHSP 2016-2019
 LHIN Annual Business
Plan
 Added criteria to NE LHIN
decision-making
framework
2
The NE LHIN identify an
Aboriginal Lead Officer to
oversee the implementation
of this plan.
 September 2016
 Patients First
 TRC Calls to Action
 Appointment made
3
Work with Aboriginal
providers to ensure quality
data collection and reporting
through LHIN-supported
training opportunities.
 Ongoing
 LHIN IHSP 2016-2019
 LHIN Annual Business
Plan
 Number of training
sessions
 % increase in report
submissions
 Enhanced data quality
4
Revisit the plan annually,
review actions achieved, and
report on progress to
to the LAHC, and the NE LHIN
Board of Directors.
 Annually
(Spring)
 LHIN IHSP 2016-2019
 LHIN Annual Business
Plan
 TRC Calls to Action
 LAHC and LHIN Board
revisit the plan annually
 Annual report to the
Board and LAHC
 Update actions for the
annual work plan
 Refinements to the plan
5
Identify targeted
engagement activities on the
specific needs of Aboriginal
people and partner with the
LAHC, health service
providers, and/or First
Nations communities.
 Ongoing
 LHIN IHSP 2016-2019
 NE LHIN Annual
Business Plan
 Patients First
 TRC Calls to Action
 Aboriginal voices are
represented and
incorporated into
planning
Aboriginal Health Care Reconciliation Action Plan | 20
Conclusion
“Building a better future is all about understanding our past. This
Reconciliation Plan is a starting point on our journey to ensure
more equitable health care services for Northeastern Ontario’s
Aboriginal people. Just as we recognize that we cannot overcome
decades of challenges, we know that we need to deliver on a
vision for the path forward, and we must take these important
first steps together.”
– Louise Paquette, North East LHIN Chief Executive Officer
This plan sets a course with guiding values, including a commitment from the North
East Local Health Integration Network to focus on strategic directions involving
opportunities, relationships, knowledge and understanding, sustainability
and evaluation.
We hope to make this journey with a load that’s lightened through the help of many
hands. We know that about 11% of Northeastern Ontario’s population is Aboriginal.
In this strong company, there are many opportunities to engage, collaborate, initiate,
and evaluate.
It’s important to also acknowledge that this plan requires the strength of relationships
that are respectful and understanding. To contribute to the success of this plan, there
is an expectation that Northeastern health service providers will grow their
knowledge in cultural competency.
In the spirit of building a stronger system of care, this plan outlines goals with
measurable targets.
It is time to begin our journey – together.
Aboriginal
HealthHealth
Care Reconciliation
ActionAction
Plan |Plan
21 | 21
Aboriginal
Care Reconciliation
Appendices
Appendix A: Environmental Scan
A. Methodology and Limitations
The environmental scan was completed through the use of the following Aboriginal data:
1. Data from NE LHIN Aboriginal engagements pertaining to the 2016-2019 Integrated Health Service Plan
and Patients First Discussion Paper was reviewed to identify priority needs of Aboriginal people.
2. The Aboriginal Peoples Survey (APS), Ontario, 2012, was reviewed to support what was heard during the
engagement sessions regarding health issues pertaining to the off-reserve Aboriginal population.
3.
Aggregate electronic medical records data pertaining to the top health conditions of the Aboriginal Health
Access Centres and Aboriginal Community Health Centre within the region was reviewed to determine if
health conditions differed in the data gathered from that in the Aboriginal Peoples survey.
4.
National Household Survey (NHS) 2011, Aboriginal Population Profiles, were reviewed to understand
the characteristics of the Aboriginal population in the region.
5. The analysis of the social determinants of health for the off-reserve First Nations population, 15 years
of age and older, Aboriginal Peoples Survey 2012 was reviewed to understand the links between the
social determinants of health and health conditions.
6. Research was conducted into the funding and delivery of Aboriginal health care services to describe
the structure for Aboriginal health care in the region.
The following limitations exist pertaining to the data:
1. The 2012 Aboriginal Peoples Survey provides data pertaining to the Aboriginal off-reserve
population. It excludes people living on Indian reserves and settlements. The APS is a thematic
survey that emphasized education, employment and health, intended to complement the Canadian
Census of Population and National Household Survey.
2. The 2011 National Household Survey (NHS), Aboriginal Population Profile, excludes data from some
Indian reserves and settlements and small towns. Some Indian reserves and settlements didn’t
participate in the NHS because enumeration was either not permitted or it was interrupted because
of natural events. Data was suppressed for towns where the Aboriginal identity population was less
than 250. The impact of incomplete information is greatest on data for First Nations people.
3. Engagement discussions did not specifically pertain to the Aboriginal Health Care and Reconciliation
Plan. Therefore, the needs identified through the engagement discussions may exclude some
Aboriginal health issues that may be considered important to the plan.
Statistical data excludes some of the Aboriginal population, so it is likely that some conditions and the
population of Aboriginal people in the region are underestimated. The data is presented to provide
a foundation for discussions pertaining to Aboriginal health care within Northeastern Ontario. The
LAHC can augment the data with their knowledge and experiences in Aboriginal health to validate or
expand the Aboriginal health care priorities.
Aboriginal Health Care Reconciliation Action Plan | 22
B. Aboriginal Population
The Aboriginal population in Northeastern Ontario is diverse. Approximately 59,410 Aboriginal people
live in the region, about 11% of the overall population within the region (Statistics Canada, 2016). The
NE LHIN has the second highest proportion of Aboriginal people living within its region (Ontario, 2015).
Within the Aboriginal population, 62% identified themselves as First Nation and 37% identified
themselves as Métis.
There are 39 First Nations, 9 Métis communities and 7 Aboriginal Friendship Centres situated within rural,
remote and urban locations across the region.
C. Health Conditions
Mental health, prevention of chronic illness and oral health is a concern for the Aboriginal youth
population. Youth, under the age of 24, comprise 41% of the Aboriginal population within the region.
Aboriginal people are experiencing physical aging due to multiple chronic conditions. They are requiring
services normally associated with aging at younger chronological ages. Aging adults, 45 years of age and
older, comprise 34% of the Aboriginal population within the region.
One quarter of the Aboriginal population could be responsible for caring for the remainder of the
population within the region.
In 2012, 63% of off-reserve First Nations people aged 15 and older in Canada reported having at least one
chronic condition, compared with 49% of the total population of Canada. Of those Aboriginal people with
a chronic condition, 41% reported one condition, 25% reported two conditions and 35% reported three
or more chronic conditions. (Statistics Canada, 2016)
The 2012 Aboriginal Peoples Survey reported that the top chronic conditions of off-reserve First Nations
people aged 15 and older were the following:
Table 1: Chronic Health Conditions, 2012 Aboriginal Peoples Survey, Canadian Off-Reserve First Nations
Chronic Condition
High Blood Pressure
Arthritis (20%)
Asthma (15%)
Mood Disorder (15%)
Anxiety Disorder (14%)
Diabetes (10%)
% of Canadian Aboriginal Population
22
20
15
15
14
10
The three Aboriginal Health Access Centres and one Aboriginal Community Health Centre (CHC) within
the region provide services to 7,832 patients out of a total Aboriginal population of 28,681 within their
catchment area. The AHACs and CHC reported the following conditions that patients have.
Aboriginal Health Care Reconciliation Action Plan | 23
Table 2
Health Condition
Diabetes Mellitus
Hypertension
Depressive Disorder/Depression
Anxiety
Post-Traumatic Stress Disorder
Intergenerational Issues
Mental Health Related Illnesses
Gastroesophageal Reflux Disease
Other Mood Disorder
# Patients
3807
997
472
442
307
292
290
283
259
The Métis Nation of Ontario reported the following pertaining to the chronic health conditions of Métis
people living within Ontario. (Métis Nation of Ontario)

The prevalence of diabetes among Métis people in Ontario is 26% higher than in the general
Ontario population.

The prevalence of chronic obstructive pulmonary disease (COPD) is 1.6 time higher among Métis
in Ontario.

Asthma is 1.2 times higher in the Métis population compared to other Ontarians, with the greatest
differences seen in youth aged 18 to 24 years.

One in five Métis citizens in Ontario suffer from osteoarthritis, a rate that is 20% higher than in
the general population.

Métis citizens have similar rates of acute kidney injury, chronic kidney disease, and end-stage
kidney disease compared with other Ontarians.
Statistics Canada reported that as the number of social determinants of health increases, the likelihood
of poor health outcomes increases.
D. Health Factors
The Chiefs of Ontario and Cancer Care Ontario reported the following health factors of First Nations
people in Ontario. (Chiefs of Ontario and Cancer Care Ontario, 2016)

First Nations people in Ontario are almost two times more likely to smoke cigarettes compared
to the general population, 50% of First Nation adults living on reserve and 44% of First Nation
adults living off-reserve compared to 26% of non-Aboriginal adults. A greater proportion of onreserve First Nation teens (30%) reported smoking than off-reserve First Nation teens (14%). Both
are significantly higher than non-Aboriginal teens (4%). Smoking rates declined within First Nation
adults as the level of education increased.

The proportion of obese men was significantly higher among First Nations living on-reserve (48%)
than those living off-reserve (33%) and non-Aboriginal men (19%). On-reserve First Nation
women were significantly more likely to be obese (49%) than off-reserve First Nation women
(28%) and non-Aboriginal women (16%).
Aboriginal Health Care Reconciliation Action Plan | 24

On-reserve First Nation women were the least likely to be physically active (27%), about half as
likely as off-reserve First Nation women (50%) and non-Aboriginal women (48%). On-reserve First
Nation men (44%) were also significantly less likely to be physically active compared to off-reserve
First Nation men (60%) and non-Aboriginal men (53%).

On-reserve First Nation adults were significantly less likely to consume the recommended
minimum of 4 servings of fruit and vegetables per day (12% men, 20% women) than off-reserve
First Nation adults (27% men, 40% women). There was no significant geographic variation
between the north and south in the consumption of fruit and vegetables.
The Métis Nation of Ontario and Cancer Care Ontario reported the following health factors of Métis
people in Ontario. (Métis Nation of Ontario)
•
Métis adults in Ontario are 1.7 times more likely to smoke cigarettes compared to the general
population (37% vs. 22%, respectively). More Métis adults living in Northern Ontario (43%) are
smokers than those living in Southern Ontario (34%). Métis teens are more likely to smoke
compared to non-Aboriginal teens (17% vs. 8%, respectively). Smoking rates declined in Métis
adults as their level of education increased.
•
Métis adults are twice as likely to exceed drinking guidelines for cancer prevention and smoke
compared to the general provincial population.
•
Over half of Métis adults in Ontario are either overweight or obese (66% men, 55% women).
•
A similar proportion of Métis and non-Aboriginal Ontarians are overweight; however, Métis adults
are more likely to be obese than the general provincial population.
•
Nearly half of all Métis adults are inactive.
•
Approximately 70% of Métis adults in Ontario fail to consume the recommended number of
vegetables and fruits daily.
E. Physical Environment
Private Dwellings by Condition
Within the 2011 National Household Survey, the total number of private dwellings occupied by an
Aboriginal household was reported at 30,360. Twenty percent (20.8%) of the private dwellings occupied
by an Aboriginal household were reported as requiring major repairs.
Mobility
Some Aboriginal people move frequently. As a result, they may experience barriers to maintaining a
continuum of health care. The 2011 National Household Survey, Aboriginal Peoples Profile reported that
15% of the Ontario Aboriginal population moved within one year prior and 42% of the Ontario Aboriginal
population moved within five years prior.
Aboriginal Health Care Reconciliation Action Plan | 25
Education
Less than half (44.5%) of the Aboriginal population aged 15 years and older possess a post-secondary
certificate, diploma or degree. Less than a quarter (22.9%) of the Aboriginal population aged 15 years and
older possess a high school diploma or equivalent as their highest certificate received.
Income of Private Households
Almost 30% of private Aboriginal households are living under the poverty line.
Figure 1: Total Income in 2010 of Private Aboriginal Households
Source 1: 2011 National Household Survey, Aboriginal Population Profile
Food Security
Food security is defined as having “physical and economic access to sufficient, safe and nutritious food to
meet their dietary needs and food preferences for an active and healthy life (Food and Agriculture
Organization of the United Nations, 2016).” In 2012, 18% of the Aboriginal population in Ontario aged 6
years and over reported low to very low food security.
Figure 2: Food Security of Aboriginal Peoples Aged 6 Years of Age and Over, Ontario
4%
9%
High or Marginal Food
Security
9%
Low Food Security
Very Low Food Security
78%
Food security not
specified
Source 2: Aboriginal Peoples Survey 2012, CANSIM Table 577-0009
Aboriginal Health Care Reconciliation Action Plan | 26
F. Structure for Aboriginal Health Care in Northeastern Ontario
The Aboriginal health care system in Northeastern Ontario is a complex system that involves federal,
provincial and First Nation jurisdictions. As illustrated in Figure 3, funding of health services spans four
different levels: federal, provincial, NE LHIN and Aboriginal Political Territorial Organizations (PTOs).
Aboriginal people access services through a variety of Aboriginal and mainstream providers that are
located both on- and off-reserve.
Figure 3: Structure of Aboriginal Health Care in Northeastern Ontario
Government of Canada
The federal government has jurisdiction over on-reserve matters. Health Canada is the lead federal
department that is responsible for health care on First Nations. It provides funding for First Nation-based
health services. Indigenous and Northern Affairs Canada (INAC) is responsible for meeting the federal
government’s responsibilities for Aboriginal people and the North. INAC transfers funds for social services
that contribute toward improved health outcomes on First Nations. The Public Health Agency of Canada
(PHAC) is responsible for health promotion, prevention and control of infectious diseases and responding
to public health emergencies. PHAC transfers funds for health-related services to off-reserve populations.
Table 3 lists the health services that are funded by federal departments.
Aboriginal Health Care Reconciliation Action Plan | 27
Table 3: Health Services Funded by the Federal Departments
Health Canada
 Children and Youth (Healthy
Child Development –
Aboriginal Head Start,
Maternal Child Health, Fetal
Alcohol Syndrome Disorder
(FASD)
 Mental Health and Addictions
(Brighter Futures Program,
Building Healthy Communities
Program, Indian Residential
Schools Resolution Health
Support Program, National
Native Alcohol & Drug Abuse
Program)
 Chronic Disease and Injury
Prevention (Aboriginal
Diabetes Initiative)
 Communicable Disease &
Environmental Health (Vaccine
Preventable Diseases, FN
Environmental Contaminants
Program, Drinking Water and
Wastewater, Communicable
Disease Emergency Planning &
Response
 Health Governance and
Infrastructure Support (Health
Planning Management,
Community Facilities, Security
Services for FNIHB Health
Facilities)
 Primary, Home and
Community Care (Public
Health Nursing Service
Delivery, First Nation Inuit
Home and Community Care,
Children’s Oral Health
Initiative)
 Non-Insured Health Benefits
(Drug, dental, vision care,
medical supplies &
equipment, mental health
counselling, medical
transportation)
Indigenous and Northern
Affairs Canada
 National Child Benefit
Program
 Assisted Living Program (In
home care, adult foster
care, institutional care and
disabilities initiative)
 Family Violence Prevention
Program
Public Health Agency of Canada
 Community Action Program
for Children (CAPC)
 Aboriginal Head Start in
Urban and Northern
Communities (AHSUNC)
 Fetal Alcohol Spectrum
Disorder Initiative
 Canadian Prenatal Nutrition
Program
Aboriginal Health Care Reconciliation Action Plan | 28
Government of Ontario
The provincial government has jurisdiction over health services. Health services on-reserve is excluded
from the province’s legislated responsibility due to the federal responsibility over Aboriginal people.
However, the provincial government does provide support for Aboriginal health matters both on and offreserve. The Ministry of Health and Long Term Care is the lead Ministry responsible for health services.
The Ministry of Children and Youth Services delivers health services geared toward children and youth.
The Ministry of Community and Social Services delivers social services and community-based supports.
These three ministries provide funding for the delivery of health services that are listed in Table 4.
Table 4: Health Services Funded by Provincial Ministries
Ministry of Health and LongTerm Care
 Homemakers Program
 Healthy Kids Community
Challenge
 Home, Community and
Residential Care Services
 Aboriginal Health Access
Centres
 HIV/AIDS and Hepatitis C
Programs
 Other Ambulance
Operations
 Community Health Programs
 Small Hospital Projects
 Disease Prevention Strategy
 Nutrition and Healthy Eating
 Prevent Disease, Injury and
Addiction
 Healthy Communities Fund
 Smoke-Free Ontario
Ministry of Children and Youth
Services
 First Nations Student
Nutrition Program
 Mental Health and
Addictions Workers
 Akwe:go Children and WasaNabin Youth Programs
through the Ontario
Federation of Indian
Friendship Centres (OFIFC)
 Aboriginal Fetal Alcohol
Spectrum Disorder and Child
Nutrition Program through
the First Nation Political
Territorial Organizations,
Aboriginal Health Access
Centres, and OFIFC
Ministry of Community and
Social Services
 Aboriginal Healing and
Wellness Strategy
(Community wellness
programs, Aboriginal
Healthy Babies/Healthy
Children Program, Mental
Health Counselling, Crisis
Intervention Services,
Healing Lodges, Health Care
and Health Promotion,
Shelters and Safe Houses,
Pre and Post-Natal Care,
Substance Abuse Treatment
Centres)
 Outpatient Hostel through
Weeneebayko Area Health
Authority (WAHA)
 Translation Services to help
people talk with health care
professionals through
WAHA (Timmins) and
N’Swakamok Friendship
Centre
 Crisis Intervention
Coordinator Services
 Healing Lodge in Shawanaga
North East Local Health Integration Network
The NE LHIN provides $39 million to 35 Aboriginal Health Service providers located on- and off-reserve in
the areas of community support services, community mental health & addictions, diabetes education, a
long-term care home, a community health centre and a hospital.
Aboriginal Health Care Reconciliation Action Plan | 29
Political Territorial Organizations
The provincial Aboriginal political territorial organizations (PTOs) deliver regionally based programs
geared toward their population. They advocate for health services for the citizens that they represent.
They also flow funds through to local communities/or deliver services within local offices to deliver
community based programs as listed in Table 5.
Table 5: Health Services Funded by Aboriginal Political Territorial Organizations
Anishinabek
Nation
Métis Nation of
Ontario
Association of
Iroquois and Allied
Indians
 Aboriginal
Diabetes
Education
 Aboriginal
Health
Babies/Healthy
Children
 HIV/AIDS
Problem
Gambling
Ontario Federation of Nishnawbe Aski
Indian Friendship
Nation
Centres
 Aboriginal
 Aboriginal
 Akwe:go Urban
 Aboriginal
Diabetes
Diabetes
Aboriginal
Healthy
Initiative
Education
Children’s
Babies/Healthy
Project
Program
Children
 Aboriginal
Healing
 Aboriginal
 Aboriginal
 Aboriginal
& Wellness
Healing &
Diabetes Program
Responsible
Strategy –
Wellness
Gambling
 Aboriginal Healthy
Community
Strategy –
Strategy
Aboriginal Healing
Wellness
Community
& Wellness
 AIDS/Healthy
Worker
Wellness
Strategy – Healing
Lifestyles
Program
Worker
& Wellness
Program
Program
 Aboriginal
Coordinators
 FASD/Child
 Aboriginal
Healthy
 Babies/Healthy
Nutrition
Babies/Healthy
Healthy
Children
 Food Security
Children
Babies/Healthy
 Addictions and
Program
Children
 Family
Mental Health
 Community
Violence
Program
Action
 HIV/AIDS
 Children’s Mental
Program for
 Problem
Health Project
Children
Gambling
(Sudbury only)
(CAPC)
 Health Outreach
 Community
Program (centres
Support
not serviced by an
Services
AHAC)
 Problem
 Lifelong Care
Gambling
Program
Prevention
(Community
Program
Support Services)
 Urban Alcohol
Fetal Alcohol
Spectrum
Disorder Program
 Urban Aboriginal
Healthy Living
Program
 Wasa-Nabin
Urban Aboriginal
Youth Program
Note: Chart is based on information available. Additional health programs may be delivered through the Aboriginal PTOs.
Aboriginal Health Care Reconciliation Action Plan | 30
First Nations
First Nations develop and implement community health programs based on their community needs. Some
First Nations have assumed responsibility for the delivery of health services under Health Transfer agreements
with Health Canada. For some First Nations that have been deemed too small for the transfer of health
services, health responsibilities have been transferred to regional Aboriginal service providers that are
overseen and controlled by community representatives. Services that are delivered directly by First Nations
may include health promotion and injury prevention, communicable disease surveillance and prevention,
home and community care, mental health and additions, diabetes education, traditional health and early
childhood development. One First Nation operates a long-term care facility and one First Nation operates a
residential addictions treatment service.
Regional Aboriginal Health Service Providers
Regionally based Aboriginal-controlled organizations deliver culturally appropriate health services
amongst multiple communities within the region. Regionally delivered services vary, but they may include
primary health care, traditional health, diabetes education, child and youth support, fetal alcohol
spectrum disorder, hospital services, ambulance services and non-insured health benefits. Table 6 lists
the regional Aboriginal organizations and the health services delivered by each.
Table 6: Services Delivered by Regional Aboriginal Health Service Providers
Organization Name
Maamwesying North Shore
Community Health Services
Communities Serviced
1 urban centre
8 First Nations
Misiway Milopemahtesewin
Community Health Centre
1 urban centre
4 First Nations
Mnaamodzawin Health Services
5 First Nations
Noojmowin Teg Health Centre
7 First Nations
Shkagamik Kwe Health Centre
1 urban centre
3 First Nations
Wabun Tribal Council
6 First Nations
Weeneebayko Area Health
Authority
1 urban centre
6 First Nations
Services Delivered
Primary health care, mental health and
addictions, community support services,
traditional health, fetal alcohol spectrum
disorder, diabetes support.
Primary health care, traditional health, mental
health, diabetes education, child and youth
support.
Community health, mental health, home care,
diabetes, healthy child development, healthy
babies/healthy children.
Primary health care, mental health, traditional
health, community nutrition, child nutrition,
fetal alcohol spectrum disorder, children’s
recreation, diabetes wellness, community
support services.
Primary health care, diabetes care, fetal
alcohol spectrum disorder, health
education/promotion, mental health, and
traditional health.
Community health nursing, patient
transportation, diabetes, crisis team
coordination, long-term care.
Community health, hospital, midwifery, renal
dialysis, Ontario breast screening
mammography, dental, diabetes support, noninsured health benefits, ambulance, diagnostic
services, laboratory, emergency room,
operating room, community mental health,
traditional healing.
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Off-Reserve Aboriginal Health Service Providers
Off-reserve Aboriginal-controlled organizations also deliver health services within Aboriginal communities
that are urban or rural based. Services may include child and youth support, problem gambling
prevention, community wellness worker services, community support services, primary care and
residential addictions treatment. Table 7 lists the off-reserve organizations and the health services
delivered by each.
Table 7: Services Delivered by Off-Reserve Aboriginal Health Service Providers
*Services listed are not provided at all locations
Organization Name
Métis Nation of Ontario offices
# Sites
4
Services Delivered
Healthy babies/healthy children, community
wellness workers, community action plan for
children (CAPC), community support services,
diabetes education, problem gambling prevention.
Friendship Centres
7*
Healthy babies/healthy children, healing & wellness
coordinators, addictions and mental health, diabetes
education, lifelong care program, healthy living
program, fetal alcohol spectrum disorder, children’s
mental health, health outreach, Akwe:go Aboriginal
children’s program, Wasa-Nabin Aboriginal youth
program.
Aboriginal Peoples Alliance of
Northern Ontario
5*
Family medical care, community based health,
access to health professionals, Aboriginal healthy
babies/healthy children, community wellness
workers, and head start.
Benbowopka Treatment Centre
1
Residential addictions treatment
Sagashtawao Healing Lodge
1
Residential addictions treatment
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Appendix B: Aboriginal Health Services in the North East LHIN
Aboriginal Health Care Reconciliation Action Plan | 33
Appendix C: Truth and Reconciliation Commission
The Truth and Reconciliation Commission (TRC) was established in 2008 under the Indian Residential
Schools Settlement Agreement. The TRC’s responsibility was to reveal the truth about Canada’s
residential schools and the ongoing legacy of the schools by:
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gathering documents and statements about residential schools,
setting up a research centre to permanently house the Commission’s records and documents,
and
issuing a report with recommendations.
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The Commission held seven national events between June 2010 and March 2014 that were attended by
approximately 155,000 participants and 9,000 registered survivors. It also held regional events and
community hearings across Canada. The Commission received over 6,750 statements from residential
school survivors and their families. The Commission also received statements from former staff and
their family members in separate interviews, events and community hearings.
The TRC issued its final report in 2015. Within the report, it issued 94 calls to action to redress the
legacy of residential schools and address the process of reconciliation pertaining to
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child welfare
education
language and culture
health
justice
Canadian government and the United
Nations Declaration on the Rights of
Aboriginal People
Royal Proclamation and Covenant of
Reconciliation
settlement agreement parties and the
United Nations Declaration on the Rights of
Aboriginal People
equity for Aboriginal people in the legal
system
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national council for reconciliation
professional development and training for
public servants
church apologies and reconciliation
education for reconciliation
youth programs
museums and archives
missing children and burial information
national centre for truth and reconciliation
commemoration
media and reconciliation
sports and reconciliation
business and reconciliation, and
newcomers to Canada.
Calls to action (Truth and Reconciliation Commission of Canada, 2015) relevant to the delivery of health
services to Aboriginal people are listed below.
Health
“18) We call upon the federal, provincial, territorial, and Aboriginal governments to acknowledge
that the current state of Aboriginal health in Canada is a direct result of previous Canadian
government policies, including residential schools, and to recognize and implement the healthcare rights of Aboriginal people as identified in international law, constitutional law, and under
the Treaties.
Aboriginal Health Care Reconciliation Action Plan | 34
19) We call upon the federal government, in consultation with Aboriginal peoples, to establish
measurable goals to identify and close the gaps in health outcomes between Aboriginal and nonAboriginal communities, and to publish annual progress reports and assess long-term trends. Such
efforts would focus on indicators such as: infant mortality, maternal health, suicide, mental
health, addictions, life expectancy, birth rates, infant and child health issues, chronic diseases,
illness and injury incidence, and the availability of appropriate health services.
20) In order to address the jurisdictional disputes concerning Aboriginal people who do not reside
on reserves, we call upon the federal government to recognize, respect, and address the distinct
health needs of the Métis, Inuit, and off-reserve Aboriginal peoples.
21) We call upon the federal government to provide sustainable funding for existing and new
Aboriginal healing centres to address the physical, mental, emotional, and spiritual harms caused
by residential schools, and to ensure that the funding of healing centres in Nunavut and the
Northwest Territories is a priority.
22) We call upon those who can effect change within the Canadian health-care system to
recognize the value of Aboriginal healing practices and use them in the treatment of Aboriginal
patients in collaboration with Aboriginal healers and Elders where requested by Aboriginal
patients.
23) We call upon all levels of government to:
i. Increase the number of Aboriginal professionals working in the health-care field.
ii. Ensure the retention of Aboriginal health-care providers in Aboriginal communities.
iii. Provide cultural competency training for all health-care professionals.
24) We call upon medical and nursing schools in Canada to require all students to take a course
dealing with Aboriginal health issues, including the history and legacy of residential schools, the
United Nations Declaration on the Rights of Indigenous Peoples, Treaties and Aboriginal rights,
and Indigenous teachings and practices. This will require skills-based training in intercultural
competency, conflict resolution, human rights, and anti-racism.
Professional Development and Training for Public Servants
57) We call upon federal, provincial, territorial, and municipal governments to provide education
to public servants on the history of Aboriginal peoples, including the history and legacy of
residential schools, the United Nations Declaration on the Rights of Indigenous Peoples, Treaties
and Aboriginal rights, Indigenous law, and Aboriginal–Crown relations. This will require skills
based training in intercultural competency, conflict resolution, human rights, and anti-racism.”
The TRC documented the experiences of people who attended residential schools and the
effects on the individuals and their families. It was important for a Northeastern Ontario health
plan to address the TRC’s calls to action.
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Learn More
Visit our website at www.nelhin.on.ca or call 1-866-906-5446
Aboriginal Health Care Reconciliation Action Plan | 36