2012-2013
ATLANTIC POLICY CONGRESS OF FIRST NATIONS
CHIEFS SECRETARIAT
MI’KMAQ MALISEET
ATLANTIC HEALTH
BOARD ANNUAL REPORT
0
TABLE OF CONTENTS
MMAHB Meetings
1. June 19, 2012
a) Agenda
b) Meeting Notes
2. October 18, 2012
a) Agenda
b) Meeting Notes
3. January 15, 2013
a)
Agenda
b)
Meeting Notes
4. Special MMAHB Meetings (2)
a) October-November 2012
b) March 2013
Health Tech Meetings
1. June 2012
c) Agenda
d) Meeting Notes
2. October 2012
c) Agenda
d) Meeting Notes
3. January 2013
a) Agenda
b) Meeting Notes
Co-Chairs Meetings
1. June 2012
a) Agenda
b) Meeting Notes
2. October 2012
a) Agenda
b) Meeting Notes
3. January 2013
a) Agenda
b) Meeting Notes
Primary Health/NIHB Committee Meeting
1. May 2012
a) Agenda
b) Meeting Notes
2. September 2012
a) Agenda
b) Meeting Notes
3. December 2012
a) Agenda/Meeting Notes
b) Agenda/Meeting Notes
C&Y/Public Health & Primary Care Committee
1. June 2012
a) Agenda
b) Meeting Notes
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Page Number
03
04
10
11
17
19
33
39
51
52
55
56
No Agenda
57
58
59
61
62
No Agenda
64
66
67
72
73
76
78
81
83
2. September 2012
a) Agenda
b) Meeting Notes
3. December 2012
a)
Agenda
b)
Meeting Notes
Wellness/Mental Wellness Committee
1. May 2012
a) Agenda
b) Meeting Notes
2. September
a) Agenda
b) Meeting Notes
3. January
a) Agenda
b) Meeting Notes
MMAHB Coordinator Job Description
MMAHB Coordinator Work Plan 2011-2012
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90
98
100
103
104
108
109
117
119
122
125
Note on the Content:
The New Terms of Reference were accepted by the MMAHB and Atlantic All Chiefs in
September 2012. The MMAHB structure was altered and is reflected in the content of
this report. For example, the Primary Health Care and Public Health Committee is now
the Public Health and Primary Care Committee and has absorbed the former Child and
Youth Committee. There is also now a Non-Insured Health Benefits Committee. For
more information on the new structure please see the APCFNC Website under
Health/MMAHB www.apcfnc.ca
For the Health Technicians portion where it says No Agenda the reason is that the new
structure was the only topic, Therefore there was no need of a formal agenda.
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MMAHB AGENDA
Tuesday June 19, 2012 at the Crowne Plaza, Moncton
9:30am-4:00pm
Coffee and Networking
Opening Prayer (Elder)
Introductions, Approval of Agenda & Minutes (Chairperson)
Note: Distribute MMAHB committee member list.
Acknowledgement of Standing Written Reports (Chairperson)
The following standing reports requested by MMAHB are: Heath Services
Integration Fund, Aboriginal Health Human Resources Initiative, Contribution
Agreement Funding, Health Information Management (ie. Panorama, Telehealth, Surveillance Capacity Project).
Regional Roundtable (MMAHB Chiefs, response from FNIHB RD)
MMAHB Subcommittee Reports (Subcommittee Co-Chairs)
Co-chairs of the 3 sub-committees provide a verbal report of key issues,
accomplishments or direction sought in 5 minutes with 5 min for questions.
Update on 2012-13 budget and organizational change (Debra)
The RD will share budget information, speak to reductions, and comment on
organizational changes affecting HQ and Regional functions & accountability.
Lunch
2011-12 Financial Information (Frank)
In response to MMAHB requests, FNIHB will present year end actuals for its
programs that pertain to mental health, addictions, and elder care. FNIHB will
provide information specific to the implementation of the strategic action plans in
these areas.
2011-12 Financial and Utilization Information on NIHB (Louise)
In response to MMAHB requests, FNIHB will present year end actuals on
utilization and cost by benefit category. This will be shown for the region as well
as the McIvor clients and Qalipu clients.
Implications of the Financial Transparency Act (Kandace)
Kandace Terris will share what she knows about possible implications of the
proposed legislation on health funding and First Nations reporting.
Proposed Terms of Reference – MMAHB & NIHB Committee
The MMAHB Evaluation Steering Committee will present proposed ToR for
MMAHB and a new MMAHB Committee on NIHB. This is a discussion item.
Finalization will happen at the fall MMAHB.
Next Meeting (date and location)
Closing Prayer
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9:30
10:00
10:15
10:20
11:00
11:30
12:15
1:00
1:20
1:40
1:45
3:00
MMAHB Meeting
June 19, 2012
Crowne Plaza, Moncton N.B.
MMAHB Members Present:
Attendees:
Voting members:
Chief Candice Paul
Chief Deborah Robinson
Chief Brian Francis
Proxy Chief Dominic Denny
Proxy Claudia Simon
Proxy John Frank Toney
Representing:
Attendees:
Representing:
APC NB Co-Chair
APC NS Co-Chair
MCPEI
CMM
MAWIW
UNSI
Debra Keays-White
Christiane Poulin
Louise Cholock
Agatha Hopkins
Tryna Booth
Proxy Brenda Roos
Proxy Frank Fleet
FNIHB
FNIHB
FNIHB
FNIHB
FNIHB
FNIHB
FNIHB
Non-voting members:
Elder John Joe Sark
Christine Gabriel
Laurie Nicholas
Susan Ross
APC Elder
APC Elder
PHC/PH Co-Chair
PHC/PH Co-Chair
James McGrath
Sally Johnson
Janet Pothier
C&Y Co-Chair
C&Y Co-Chair
Wellness Co-Chair
AFN
AFN
Mi’kmaq Nation
FNIHB
FNIHB
FNIHB
Chief Mi’sel Joe
Chief George Ginnish
Chief Aaron Sock
Chief Leroy Deny
Chief Andrea Paul
APC
Wade Were
MMAHB Members Absent:
Vice Chief Roger Augustine
Vice Chief Morley Googoo
Grand Chief Ben Sylliboy
Leila Gillis
Jim Millar
Kandace Terris
Miawpukek
UNBI
MAWIW
UNSI
CMM
Guests/Observers Present:
Amanda Peters
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FNIHB
Chelsea Googoo
Loraine Etter
Chief Darlene Bernard
APC
APC
MCPEI
Peter Birney
Roseanne Sark
Peter McGregor
UNBI
MCPEI
FNIHB
Opening Prayer: Elder John Joe Sark
1.) Introductions, Approval of Agenda and Minutes: Chief Candice Paul:
-
Minutes approved by consensus by the committee.
Approval of Agenda: Debra Keays White and Tryna Booth.
2.) Acknowledgement of Standing Written Reports: Chief Candice Paul
3.) Regional Roundtable (MMAHB Chiefs, response from FNIHB):
UNSI Proxy John F. Toney: no report
MCPEI Chief Brian Francis: The Chief expressed two concerns: 1) the Budget 2012
federal funding reductions, and 2) the number of PEI First Nations residents prescribed
methadone. As per Action Item #6 in the MMAHB March minutes, Debra Keays-White
noted FNIHB (Dr. Bailey) had committed to prepare an analysis of methadone use by
community/province for MMAHB. FNIHB will aim to have this available for MMAHB’s
next meeting.
MAWIW Proxy Claudia Simon: no report
Chief Deborah Robinson: The Chief expressed a concern regarding the regulation of
marijuana growing operations on reserve, and the environmental health impacts. Debra
Keays-White will contact the appropriate Health Canada authorities regarding the
growing of medicinal marijuana and prepare a briefing. She will also have FNIHB’s
Regional EHO to report to her on environmental health impacts.
Action Item #1: Debra Keays-White will provide a briefing on the federal regulations
and potential environmental health impacts of FN residents growing medicinal
marijuana on reserve.
APC Co-Chair Chief Candice Paul: The Chief expressed strongly her concern
regarding the Budget 2012 federal funding reductions that affect First Nations
organizations. She urged MMAHB Chiefs to take collective action with the AFN by
sending a clear message to the Prime Minister regarding First Nations opposition to
these reductions.
Action #2: APC will organize a discussion among MMAHB Chiefs to discuss the
impacts of the federal funding reductions in an in-camera session after the MMAHB
meeting.
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CMM Proxy Dominic Denny: Mr. Denny asked Janet Pothier to voice CMMs
concerns. Janet expressed concerns regarding the Budget 2012 federal funding
reductions to First Nations organizations. She raised a fear that First Nations will
continue to face more funding reductions in subsequent years. She agreed to continue
to discuss this matter in a separate session with MMAHB Chiefs after the MMAHB
Meeting.
4.) MMAHB Committee Reports:
A.) Wellness Committee:
Janet Pothier referred to the Committee’s written report in the MMAHB meeting
package. Janet highlighted the successful “No Harm in Trying” conference. A
conference report is also found in the MMAHB meeting package.
Janet mentioned that the Committee is without a FNIHB Co-chair since Charmane
Kaye’s retirement. Debra Keays-White indicated that Charmane would be able to
remain as the Wellness Co-Chair since she is doing a casual placement with FNIHB
carrying the Indian Residential Schools Health Support Program (IRSHSP) file.
Janet raised a concern that Brighter Futures-Building Healthy Communities (BF-BHC)
funding may be reduced or eliminated. She also expressed a concern with the sunsetting of the IRSHSP funding. Debra also stated that she did not believe that the
IRSHSP funding would end March 2013. She will ask Charmane Kaye to keep the
Wellness Committee up to date as more is known about IRSHSP funding post 2012-13.
Debra stated that she was not aware of any planned reductions in the BF-BHC area. In
fact, FNIHB has specifically highlighted support for a continuum of mental wellness
programs and services as a key area in its national strategic plan.
Action Item #3: Debra agreed to confirm her understanding about the BF-BHC funding
and communicate the same to Janet in writing.
Janet indicated that the new illicit drug called “Bath Salts” is becoming a concern for
First Nations as it is extremely dangerous. FNIHB commended Pictou Landing First
Nation for its work with its local DHA on addressing this new concern.
Action Item #4: Dr. Poulin stated that she would provide the Wellness Committee
information on Bath Salts from the Canadian Centre for Substance Abuse.
Chief Candace Paul stated the use of methadone is increasing and mental health
counselling should be available for those taking it. Roseanne Sark raised a concern that
NNADAP treatment centres do not admit individuals on methadone. Dr. Poulin stated
that FNIHB is encouraging change through its NNADAP Modernization Framework,
however, treatment centres are operated by boards of directors comprised of First
Nations Chiefs. Chief Robinson noted that treatment centre staff qualifications and
compensation are also related issues. Debra suggested that MMAHB should invite the
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Regional Addictions Partnership Committee and the NNADAP Treatment Centres to a
MMAHB meeting to present their admission policies and programs, followed by a
discussion of addictions needs and possible approaches to addressing these gaps.
Action Item #5: Amanda Peters will work with the Wellness Committee to organize a
special session on addictions treatment involving MMAHB and representatives from
RAPC and the NNADAP treatment centres.
B.) Child and Youth Committee:
James McGrath and Sally Johnson referred to their written report in the MMAHB
meeting package. They highlighted that they would be presenting a recommended
Strategic Action Plan to address the Chiefs’ Child and Youth priority in September as
per the previously agreed to timeline.
The Co-Chairs described 4 options for the allocation of Fetal Alcohol Syndrome
Disorder funding to Atlantic First Nations. Funding ends March 31, 2013, and a new 2
year allocation is available until March of 2015. Currently, 20 First Nations are served
by 8 projects using a total of $467K in annual funding. The 4 options and
recommendation were developed by the Committee. The Committee recommended
continuing the current funding arrangements until March 31, 2015.
Decision: MMAHB accepted the Committee recommendation to maintain the status
quo distribution of the FASD funding for two more years until March 31, 2015.
Motioned by Chief Brian Francis. Seconded by Dominic Denny. Unanimously
approved.
C.) Primary Health Care & Public Health Committee
Laurie Nicholas and Susan Ross referenced their written report in the MMAHB meeting
package. No points were highlighted.
5.) Update on 2012-13 Budget and Organizational Change:
Debra Keays-White did not use a Powerpoint Presentation or have a written report.
She reiterated the points made by ADM Gideon when she addressed the Atlantic All
Chiefs Forum on the Budget 2012 federal funding reductions. APC prepared a briefing
note for the MMAHB participants on the ADM’s presentation and inserted it in the
MMAHB meeting package. Debra also spoke briefly about the Branch’s development of
a new regions/headquarters accountability structure in light of the new headquarters
organizational structure and the new FNIHB national Strategic Plan that is expected to
be distributed early this fall. Changes to the region’s organizational structure are also
expected to be known in the months ahead.
Debra used the rest of her allotted time to field questions:
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Q. Why did some PTOs get bigger cuts than others?
A. Debra stated that direct service delivery portion of the PTO funding was protected.
After the reductions, each of the provincially based First Nations organizations in
Atlantic Canada will have similar levels of health funding for the area of
consultation/liaison.
Q. Why were cuts done in the first year instead of year three?
A. These decisions were made in Ottawa.
Q. Should we expect more cuts over the next couple of years? Communities are
already struggling because the funding formula does not rise with population increases.
A. We do not expect further cuts in the next couple of years. Health Canada has tried to
address the need to reduce funding in the first year, and we are not looking to stabilize.
Communities will continue to receive a 3% annual increase in their Indian Envelope
funding.
Q. Who decided to make the official cuts, was it HQ or FNIHB Atlantic?
A. The overall funding reduction targets as well as the overall areas to be protected or
reduced were set in Ottawa. Within these parameters, Ottawa sought and approved
proposals from the regions to meet the funding reduction targets.
Q. Why were some regions affected less than others?
A. BC was not reduced because they are in the midst of a tripartite agreement
development. Tripartite agreements are encouraged by the federal government.
6.) 2011-2012 Financial Information (Frank Fleet):
Frank used a Powerpoint Presentation of which a hard copy was included in the
MMAHB meeting package. Frank was responding to action items #8 and #9 of the
March 2012 MMAHB meeting which asked for financial information related to the
activities in the strategic action plans (mental health, addictions and elder care).
Chief Candice Paul asked about the “NNADAP staff certification” item ($200,800). The
Chief wants to know when her NNADAP prevention staff receive certification incentives.
The Chief asked a variety of questions on this topic. Debra noted that this topic had
been raised at a previous MMAHB meeting and FNIHB had a prepared a briefing note
to MMAHB.
Action Item #6: Dr. Poulin will provide MMAHB an update to the Sep 16, 2011 briefing
note on the topic of NNADAP staff certification incentives.
7.) 2011-2012 Financial and Utilization Information on NIHB
In the interest of time, this item deferred to next meeting.
8.) Implications of the Financial Transparency Act
8
In the interest of time, this item deferred to next meeting.
9.) Proposed Terms of Reference – MMAHB & NIHB Committee:
Chief Darlene Bernard, member of the MMAHB Evaluation Committee, delivered a
Powerpoint presentation that outlined proposed terms of reference for MMAHB and a
new MMAHB committee focused on Non-Insured Health Benefits. See the MMAHB
meeting package for a hard copy of the presentation. Chief Bernard stated that the
Committee is looking for feedback from MMAHB, and that finalization of the Terms of
Reference would be sought at the September MMAHB meeting before seeking approval
by the Atlantic All Chiefs Forum.
Action Item #7: Amanda Peters will clarify whether there is support for an Innu Nation
member of MMAHB.
Decision: The MMAHB Chiefs/Proxies unanimously agreed that under the Scope of
Decision Making section of the MMAHB Terms of Reference decisions of $50K to
$250K should move the not be decided at the MMAHB committee level, but decided at
MMAHB level itself upon receiving a recommendation from the appropriate MMAHB
committee. The FNIHB MMAHB members abstained from voting on the decision.
10.)
Federal Tobacco Control Strategy (FTCS) First Nations and Inuit
Stream
With the consent of MMAHB, a late item was added to the agenda by FNIHB. Brenda
Roos explained that four days ago, FNIHB was made aware that contribution funding
through the renewed FTCS (FN&I Stream) will be made available to the region to
support an estimated five projects. These projects would be expected to develop and
implement comprehensive, integrated and sustainable tobacco control strategies into
community based programming, services, and policies. Projects would be expected to
be aligned with the evidence based approach outlined in the World Health
Organization’s Framework Convention on Tobacco Control. A comprehensive strategy
includes a full range of interventions: prevention, cessation, education, protection,
pricing, surveillance, and evaluation. A total estimated $500K may be available to the
region for such projects each year for 5 years. Timelines are very short, projects to be
identified in July for the projects to be rolling in August.
11.)
Next Meeting: There will be a 2 day MMAHB meeting on September 19
and 20 in Dartmouth.
12.)
Closing Prayer: Elder Christine Boone
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MMAHB AGENDA
October 18th, 2012 (9:30am-4:00pm) and October 19th (9am-noon)
APC Head Office, Dartmouth
Coffee and Networking
Opening Prayer (Elder)
Introductions, Approval of Agenda & Minutes (Chairperson)
Acknowledgement of Standing Written Reports (Chairperson)
The following standing reports requested by MMAHB are: Heath Services Integration Fund,
Aboriginal Health Human Resources Initiative, Contribution Agreement Funding, Health
Information Management (ie. Panorama, Tele-health, Surveillance Capacity Project).
Regional Roundtable (MMAHB Chiefs, response from FNIHB RD)
MMAHB Committees Reports (Committee Co-Chairs)
Each MMAHB committee (co-chairs) provide a 5 min verbal report of key issues,
accomplishments or direction sought. 5 min for questions.
Implications of Bill C-27, First Nations Financial Transparency Act (Kandace Terris)
Kandace Terris will share what she knows about possible implications of the proposed
legislation on health funding and First Nations reporting.
LUNCH
Plan MMAHB Health Information Session (Agatha Hopkins)
Discuss agenda, date, and invitee list to confirm scope of session on health information.
2011-2012 NIHB Usage Information (Louise Cholock)
In response to MMAHB requests, FNIHB will present year end actuals on utilization and cost by
benefit category. This will be shown for the region as well as the McIvor clients and Qalipu
clients.
Child and Youth Strategy (Sally Johnson & James McGrath)
Child and Youth Co-chairs will present the final Atlantic First Nations Child and Youth Strategic
Action Plan. Child and Youth Committee will seek endorsement for the plan.
Update and Next Steps for Implementing Recent MMAHB Decisions
Drug Utilization and Prevention Projects Funding (Christiane Poulin)
Federal Tobacco Control Strategy Projects Funding (Sandra Musgrave)
MMAHB Terms of Reference and MMAHB Committees Terms of Reference (Amanda Peters
and Wade Were)
Setting of Next Meeting Date and Closing of Day 1
Day 2
Coffee and Networking
Dialogue with Atlantic Treatment Centres (Treatment Centre Directors)
The Directors of the Atlantic First Nations treatment centres will present on their treatment
philosophy, programming and modernization activities/plans. A facilitated discussion will follow
on the topic of identifying and addressing unmet addictions treatment needs within the greater
provincially/federally funded health system.
Closing Prayer
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9:30
10:00
10:25
10:30
11:15
11:50
12:00
1:00
1:30
2:00
3:00
4:00
9:00
9:15
12:00
MMAHB Meeting
October 18, 2012
APC Head Office, Dartmouth, Nova Scotia
Attendees:
Voting members:
Chief Candice Paul
Chief Deborah Robinson
Chief Brian Francis
Chief Andrea Paul/L. Francis
Chief Aaron Sock
Chief Leroy Denny
Chief George Ginnish
Non-voting members:
Elder John Joe Sark
Christine Gabriel
Proxy Claudia Simon
Susan Ross
Vice Chief Roger Augustine
Chief Mi’sel Joe
MMAHB Members Present
Representing:
Attendees:
Representing:
APC NB Co-Chair
APC NS Co-Chair
MCPEI
CMM
MAWIW
UNSI
UNBI
Debra Keays-White
Leila Gillis
Louise Cholock
Agatha Hopkins
Tryna Booth
Sandra Musgrave
FNIHB
FNIHB
FNIHB
FNIHB
FNIHB
FNIHB
APC Elder
APC Elder
PHC/PH Co-Chair
PHC/PH Co-Chair
James McGrath
Sally Johnson
Janet Pothier
Morley Googoo
C&Y Co-Chair
C&Y Co-Chair
Wellness Co-Chair
AFN Vice-Chair
MMAHB Members Absent
AFN Vice-Chair
Kandice Terris
Miawpukek NFLD Charmane Kay
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FNIHB
Wellness Co-Chair
Grand Chief Ben Sylliboy
Mi’kmaq Nation
Christiane Poulin
Amanda Peters
Chelsea Googoo
John Paul
Gerald Gloade
Janna MacKay
Joe Denny
Rose Purdy
Guests/Observers Present
APC
Wade Were
APC
Roseanne Sark
APC
Mindy Denny
UNSI
Gillian Bailey
UNSI
Dougall MacDonald
NADACA
Lloyd Gould
NADACA
Leanna MacLeod
FNIHB
FNIHB
MCPEI
UNSI
FNIHB
AANDC
NADACA
NADACA
Agenda Items
Notes
1. Opening Prayer
2. Introductions,
approval of agenda &
minutes
Grand Chief Sylliboy
 Co-chairs Chief Candice Paul & Leila Gillis.
 Agenda Item #5 is deferred. No additions. Acceptance moved
by Chief George Ginnish and seconded by Sandra
Musgrave.
 Review of minutes: Acceptance moved by Leila Gillis and
seconded by Chief George Ginnish.
 Status of Action Items from June 19th minutes:
o Action Item #1: completed.
o Action Item #2: completed.
o Action Item #3: completed.
o Action Item #4: completed.
o Action Item #5: completed.
o Action Item #6: completed.
o Action Item #7: completed.
Chief Candice Paul acknowledged that the MMAHB requested standing
reports are in the meeting packages.
Chief Candice Paul (APC Co-Chair)
 Chief Candice referenced one of the six strategic directions (#5)
from the Mental Health Strategy for Canada that calls for access
to a full continuum of culturally safe mental health services for
3. Acknowledgement
of Standing Reports
4. Regional
Roundtable
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Actions
Agenda Item #5 deferred until
next meeting.
(Item #5 is “Implications of Bill C27, First Nations Financial
Transparency Act”.)
Related to (June) Action Item #3,
FNIHB agreed to report at the
Mental Wellness Committee on
how its various programs are
intended to contribute to Mental
Wellness.
Action Item #1: APC to draft a
letter to the federal Minister of
Health communicating the
perspective of the MMAHB Chiefs
Agenda Items
Notes

First Nations. The Chief asked about the status of this
recommendation, and noted the importance of having such a
continuum developed with First Nations. Leila stated that
FNIHB is in the early stages of planning a Canada-wide
engagement process to develop a First Nations mental wellness
continuum framework, and added that she expects that the
MMAHB Mental Wellness Committee will be involved.
Concerned with NIHB’s orthodontics and direct billing and wants
clarification on the process. NIHB’s Regional Dental Officer to
follow up with Chief Candice.
Chief George Ginnish (UNBI)
 Chief George wants to ensure that the Atlantic Child and Youth
Strategic Action Plan is not lost in the new larger Public Health
and Primary Care Committee of the MMAHB. Leila confirmed
that the Action Plan needs to be implemented by FNIHB, APC,
and Atlantic First Nations. The new Public Health and Primary
Care Committee will track progress.
 Chief George reflected on the importance of the federal
government holding NIHB-defrauding pharmacies accountable.
Leila explained that there is a rigorous audit process at NIHB
that flags issues and there is a process for recovery when fraud
occurs.
 Chief George noted that UNBI has been seriously impacted by
the recent federal funding cuts impacting the viability of the
entire organization. Leila stated that FNIHB is willing to work
with UNBI on ensuring continuity of services in light of the
budget cuts.
Chief Brian Francis (MCPEI)
 Chief Brian asked what is the role of FNIHB’s Physical Activity
Specialist given it has no funding for these programs. Leila
stated that the Specialist has a small ADI-based budget and
funds modest proposals from communities. The Specialist also
helps communities develop ideas/proposals around physical
fitness and promotes access to non-FNIHB sources of funding.
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Actions
on advancing strategic direction
#5 of the Mental Health Strategy
for Canada.
Action Item #2: FNIHB to provide
a written report on the role and
activities of the Physical Activity
Specialist. Included in the report
should be success stories where
communities have accessed nonFNIHB sources of support.
Agenda Items
5. MMAHB Committee
Reports
Notes
Actions
No response from CMM, UNSI or MAWIW Council
Child and Youth Committee (Co-chair James McGrath)
 A written report was provided. James gave a verbal update on
the work of the committee which focused heavily on the
development of a Child and Youth Strategic Action Plan.
Wellness Committee (Co-Chair Janet Pothier)
 A written report was provided. Janet gave a verbal update on
the work of the committee which focused largely on preparing
for the MMAHB-NNADAP treatment joint meeting, and the
allocation of DUPP (drug utilization, prevention, and promotion)
projects funding.
 Janet noted that FNIHB Atlantic’s mental health section has
many position vacancies which is concerning. Leila indicated
that FNIHB was in the process of staffing.
 Also more broadly, Leila noted that FNIHB Atlantic will be
looking to engage MMAHB on its transition plan in the coming
months. The plan is meant to guide the FNIHB Atlantic’s
organizational design to best support the implementation of the
national strategic plan and the new accountability framework.
John Paul noted the importance of FNIHB organizational design
to the work of the communities.
PHC&PH Committee (Co-Chair Susan Ross)
 A written report was provided. Susan gave a verbal update on
the work of the committee which focused on the sharing of
success stories from committee members.
 Chief Candice Paul inquired about a letter she received asking
her to participate in a national evaluation of the FNIHCC
program. The Chief expressed concern that this letter was not
supported by sufficient background information (framework, etc.)
nor was it communicated through the PHC&PC Committee.
Dougal asked if the survey would differentiate between Health
Canada and AANDC home care/support.
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Action Item #3: FNIHB will
provide APC a fact sheet on the
national FNIHCC evaluation. The
fact sheet can be distributed to
MMAHB Chiefs and the PHC&PH
committee members.
Agenda Items
6. 2011-2012 NIHB
Usage Information
(moved to 11:30am)
7. Atlantic First
Nations Child and
Youth Strategic Plan
Notes
Louise Cholock delivered a Powerpoint presentation of which copies
were included in the meeting packages.
 Louise stated that region receives additional funding for the
Qalipu’s NIHB costs. The final budget is expected to be known
in April 2013. The Qalipu enrollment process continues until
November 2012, and the number of Qalipu is expected to far
exceed original estimates. Concern was raised that Qalipu and
McIvor will eventually negatively impact pre-existing regional
clients of NIHB.
 AANDC was asked whether it will seek additional funding to
support communities to service a higher Registered Indian
population resulting from the McIvor decision. AANDC
continues to review the numbers to assess the materiality of the
McIvor decision.
 A concern was expressed that the Short Term Crisis
Intervention Mental Health Counselling continues to be
underutilized.
Child and Youth Committee Co-chairs James McGrath & Sally Johnson
delivered a Powerpoint presentation on the recommended Atlantic First
Nations Child and Youth Strategic Action Plan
 The Co-chairs stressed how the implementation of the Plan
depends on community level partnerships. Communities are
encouraged to use their interagency committees and be
inclusive of social sector and others.
 AANDC asked to have the Strategic Action Plan presented to
Child and Family Services Agencies across the region.
 The Committee was commended for its development process
and final product. It was encouraged to seek opportunities to
present at national tables.
Decision: MMAHB endorsed the Atlantic First Nations Child and
Youth Strategic Action Plan as presented. Motioned by Chief
George Ginnish and seconded by Louise Cholock. Unanimously
passed.
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Actions
Action Item #4: FNIHB will
repeat this NIHB financial and
utilization presentation in a year
(including Qalipu and McIvor
analyses).
Action Item#5: MMAHB asked
the NIHB Committee to look at
how the utilization of the
STCIMHC benefit can be
increased through such activities
as promotion and removal of
barriers.
Agenda Items
Notes
Actions

8. Update & Next
Steps for
Implementing
MMAHB Decisions
Agatha presented an approach to planning and holding a
MMAHB Health Information Management Session in January
2013, and sought MMAHB’s support to proceed.
Decision: MMAHB will participate in a Health Information
Management session in 2013. Motioned by Chief George Ginnish
and seconded by Chief Brian Francis. Unanimously passed.
 Leila provided an update on the DUPP funding: Funds will roll
out to the successful proponents of the RFP Process in January
2013.
 Leila provided an update on the Federal Tobacco Control
Strategy funding. MMAHB has previously decided on how it
would like to see the funding administered in the region. FNIHB
is discussing roll out at a national level.
 Amanda spoke about the next steps in implementing the
recently approved terms of reference for MMAHB and its
committees.
9. Setting of Next
Meeting Date &
Closing of Day 1
MMAHB will next meet on January 15 and 16, 2012 at the Membertou
Trade and Convention Centre.
Action Item #6: APC will send
out a calendar invite for MMAHB’s
next set of meeting dates.
Note: Day 2 Special Meeting on Addictions Notes are found in the Report from Janet Rhymes, Consultant. See attached
16
Meeting Information
DATE: January 15, 2013
LOCATION: Membertou Trade and Convention Centre, Membertou Nova Scotia
Agenda Items
Item
Time
9:00-9:15
9:15-9:45
Opening and Introductions
General Items



9:4510:45


Committee Co-chairs Report
11:1512:00
Regional Roundtable
3:30 –
5:00



Amanda Peters (APC)
Role of MMAHB
Scope of Decision Making
Responsibilities of Members
Meeting Processes (motions etc)
Meeting schedules
MMAHB Cycle
Chiefs Health Priorities and Strategic Action
Plans
Role of the Committees
Questions
10:4511:15
12:0012:30
12:301:30
1:30-3:30
Co-Chairs
Acceptance of Agenda
Review of Minutes and Action Items
Acknowledgement of Written Reports
MMAHB Orientation







Presenter
Committee Co-chairs
NIHB Committee Report
Public Health and Primary Care Report
Mental Wellness Report
Regional MMAHB Chiefs
and Debra Keays-White
(FNIHB)
Lunch
2013-14 Funding Decisions
FNIHB Transition Plan
Report on Addictions Meetings



Review of the reports from the Oct 19 and Nov
20
Regional Health Survey Data
Direction to the Mental Wellness Committee on
next steps
5:00-5:15
AAEDIRP Research Project – Addictions and
Economic Development in Atlantic Aboriginal
Communities.
5:00-5:15
Resolutions for All Chiefs
17
FNIHB Committee CoChairs
Debra Keays-White
(FNIHB)
Janet Rhymes, Consultant
Mindy Denny, RHS
Coordinator
Mental Wellness
Committee Co-Chairs
Margaret Donahue, APC
AAEDIRP
Amanda Peters, APC
Health
Amanda Peters, APC
5:15-5:30
Closing
18
MMAHB Meeting
January 15, 2013
Membertou Trade & Convention Center
Voting Members
Present
Chief Brian Francis
MCPEI
Chief Andrea Paul
CMM
Chief Norman Bernard
UNSI – 11am
Debra Keays-White
FNIHB
Absent
Chief Candace Paul
UNBI
Chief Aaron Sock
MAWIW
Chief Mi’sel Joe
NL FNs
Non-Voting Members
Present
Chief Deborah Robinson APC Co-Chair (NS)
Absent
Vice Chief Morley
Googoo
Janet Pothier
Gillian Bailey
AFN Vice Chief (NS) –
1pm
MWC Co-Chair (FN)
MWC Co-Chair (FNIHB)
Roseanne Sark
Leila Gillis
PHPC Co-Chair (FN)
PHPCC Co-Chair
(FNIHB)
19
Vice Chief Roger
Augustine
Elder Margaret Jadis
AFN Vice Chief-NB
Elder Christine Boone
Sally Johnson
NB Elder
NIHBC Co-Chair
(FN)
PEI Elder
Louise Cholock
Dougal MacDougall
NIHBC Co-Chair
(FNIHB)
AANDC
John Paul
Amanda Peters
Chelsea Googoo
Laurie Nicholas
Gerald Gloade
Guests in Attendance
APC
Kelly Bonnell
APC
Tryna Booth
APC
Wade Were
MAWIW
Janet Rhymes
UNSI – RHS Analyst
Agenda Items
1. Opening and
Introductions
-
-
2. General Items:
- Acceptance of
-
Notes
The meeting was scheduled to start at 9:15am. At 9:45am,
in the absence of a quorum, the voting members present
decided to begin the meeting by discussing items that did not
require a vote. With the agreement of the Chiefs, Debra
Keays-White chaired the morning portion of the meeting, and
presented on the Transition Plan (item #7). When a quorum
was achieved at 11am, Debra confirmed the action item
regarding the Transition Plan for the record. Debra also
acknowledged the special effort made by Chief Norman, who
had only been informed of the meeting on the day of the
meeting due to an incorrect email address.
The FN representatives elected Chief Brian Francis to chair
the afternoon portion of the session. FN voting members
agreed to select a Co-Chair for future meetings after this
meeting.
The agenda was accepted as distributed. The order of the
items was managed by the Chairs.
20
AANDC
FNIHB
FNIHB
APC’s Consultant
Actions
Action Item #1: At the May
MMAHB meeting, Frank Fleet will
Agenda Items
Agenda
- Review of Minutes
action items
- Acknowledgement
of Written Reports
-
-
3. MMAHB
Orientation
-
Notes
The minutes of the October 2012 meeting were accepted as
distributed.
MMAHB reviewed the action items from the October
meeting:
o Transparency Act Implications will be covered at the
next meeting of MMAHB by Frank Fleet.
o FNIHB agreed to report on how its programs are
intended to contribute to mental wellness, and this will
be done as part of the strategic action planning work
of the Mental Wellness Committee.
o #1: APC is in the process of drafting a letter to the
federal Minister of Health communicating the
perspective of the MMAHB Chiefs on advancing
strategic direction #5 of the Mental Health Strategy of
Canada
o #2: Completed; the report is attached in the MMAHB
packages.
o #3: Completed; the evaluation has been sent to the
MMAHB Chiefs.
o #4: Presented during the October 2012 meeting and
will be done again at fall MMAHB meeting
o #5: The NIHB Committee has been tasked to
determine how to increase the utilization of the
STCIMHC benefit
o #6: Completed
Debra acknowledged the standing reports requested by
MMAHB located in the meeting packages.
Actions
report on how the FNs Financial
Transparency Act will impact
health funding agreements.
Action Item #2: APC Staff will
Amanda Peters and Wade Were presented the MMAHB
prepare MMAHB Orientation
Orientation. In detail the presentation included: the role of
binders for the MMAHB members.
MMAHB; the scope of decision making for MMAHB, the
committees and FNIHB; the responsibility of all the members;
21
Agenda Items
4. Committee Cochairs Report:
- NIHB
- PH and PC
- Mental Wellness
Notes
the meeting process and scheduling; the MMAHB Cycle; the
work being done for the 4 priorities of the Chiefs’ and the
strategic action plans; and the role of the MMAHB
committees. A few questions and comments were made
around attendees to MMAHB meetings and communications
to the Chiefs. Amanda indicated that APC would be leading
the development of a communications plan for MMAHB.
-
-
-
Each committee introduced their Co-Chairs, provided the
MMAHB a written report, and spoke briefly on highlights in
their reports. The priority for each Committee was the
development of a 2013-14 work plan.
The NIHB Committee noted that they would be leading work
on the short term crisis intervention mental health counselling
benefit.
The Primary Care and Public Health Committee advised that
the FNIHB Co-chair would change with the departure of Leila
Gillis. The committee also highlighted its work in
championing the Strategic Action Plan on Child and Youth
Health.
The Mental Wellness Committee provided an update on the
DUPP funded projects, and explained that it will meet with
RAPC later in the week to establish linkages. The Committee
recommended the development of a single Mental Health
and Addictions Strategic Action Plan that built on previous
work and linked to the national Mental Health Continuum
engagement process.
Decision: MMAHB unanimously directed the Committee to
return to the next MMAHB meeting with a plan and timeline
for the engagement and development of a MH&A Strategic
Action Plan.
22
Actions
Action Item #3: At the May
MMAHB meeting, the Mental
Wellness Co-Chairs will
present a project plan and
timeline for the engagement
and development of a MH&A
Strategic Action Plan
Agenda Items
5. Regional
Roundtable
Notes
-
-
-
Debra introduced the Roundtable session by emphasizing
that this was an opportunity for each voting member to
acknowledge achievements or milestones as well as
issues.
Chief Andrea Paul:
(1) Gave a brief update from the recent AFN CCOH
(Chiefs Committee on Health) meeting that took place
in November. The CCOH will do a newsletter with fact
sheets. The next quarterly CCOH meeting is Feb 4-5.
(2) Asked about the status of the PANS (Pharmacy
Association of Nova Scotia) negotiations with FNIHB.
Louise stated negotiations are at a stalemate since
May 2012, but status quo services continue and are
anticipated to do so.
(3) Asked whether the region was going to support an
Elders Gathering. Debra noted that she understands
that the Chiefs are supportive of a Gathering. FNIHB
is willing to partner with others, and would consider a
funding proposal. The Elder Care Working Group is
trying to determine a focus and would like to hear from
Chiefs. Chief Norman indicated his communities
focus is reconnecting elders and youth.
Chief Brian Francis:
(1) Asked what MMAHB Committee is the lead monitoring
the implementation of the Elder Care Strategic Action
Plan indicating that the NIHB Committee would be
preferred. Debra agreed that a Committee needed to be
designated as the lead, and that FNIHB would need to
discuss.
(2) Want FNIHB to include First Nations input in the hiring
23
Actions
Action Item #4: Louise will
provide APC and update on
the FNIHB’s negotiations with
PHANS for distribution to
MMAHB Chiefs.
Agenda Items
Notes
of the new Mental Wellness Lead. Debra said the job
description is in classification. She noted that she would
like FN involvement in the development of a Statement of
Merit and interview questions, and will seek a FN
representative. (3)Asked for the status of the FN’s
component of the Federal Tobacco Strategy. Debra
stated that decisions on Tobacco Strategy next steps are
being made in Ottawa.
(4) Asked for the status of FNIHB’s development of a
Framework for a Mental Wellness Continuum. Debra
stated that regional engagement will happen in the new
year with the oversight of an interim FNIHB Mental
Wellness lead and the involvement of the Mental
Wellness Committee.
- Chief Norman Bernard:
- Expressed concerns about the aftercare of people with
addictions. He feels more financial assistance to
aftercare programs is needed to avoid relapses. Debra
stated that she looked forward to discussing such matters
under the addictions item later in the agenda.
- John Paul:
The voting members asked John Paul to provide an
update on the Ottawa meeting with PM Harper and the
Chiefs. He spoke of how the Prime Minister responded to
the 8 major points raised by the AFN:
1.) The PM agreed to work with FN Chiefs on issues with
treaties and to establish a new cabinet committee.
2.) On land claims: The PM agreed with fair facilitation on the
comprehensive claims policy rather than extinguishment.
3.) On resources: develop a framework of shared
governance for revenue sharing; FN to work more closely
with the provinces.
24
Actions
Agenda Items
4.)
5.)
6.)
7.)
8.)
-
Notes
Legislation on Bill C-38 and Bill C-45: to respect and to
rebuild nation building; the PM is aware of the flawed
Indian Act: wants to work with FN and provide more
flexibility, open for suggestions on an effective Indian Act.
Transforming the fiscal/funding relationship: The PM’s
statement: First Nations’ receive annual funding
increases.
National inquiry on Violence against FN Women: The PM
agrees with the Chiefs that violence against all women
should end is open for suggestions.
Shannon’s Dream: The PM agrees about the importance
of education and for national consultation; discussion
needed for post-secondary education at some point.
Effective progress of the machinery of the government:
establish a committee immediately on all national
Aboriginal issues: The PM agreed and conceded a need
for political and central oversight at Privy Council office to
achieve objectives.
Debra Keays-White:
(1) Debra indicated to Chiefs that contribution funding
would be released to bands earlier in 2013-14.
(2) FNIHB is focused on working with bands to get
outstanding reports so that funding does not need to
be held back.
(3) Debra noted that with very tight controls on travel,
FNIHB needs to plan to attend large meetings like
MMAHB well in advance so that approvals from
Ottawa can be obtained. Adherence to the planned
MMAHB meeting dates is essential.
(4) Leila Gillis was thanked for her years of service. John
Paul echoed the recognition of Leila’s contributions.
25
Actions
Agenda Items
6. 2013-14 Funding
Decisions
-
Notes
Amanda and Wade made a Powerpoint presentation on
the 2013-2014 contribution funding decisions and made
recommendations on behalf of the MMAHB committees.
The presentation was included in the meeting package.
Actions
Decision: MMAHB unanimously accepted all the
committees’ recommendations listed in the Powerpoint
presentation.
7. FNIHB Transition
Plan
Debra delivered a Powerpoint presentation on the newly
proposed FNIHB Transition Plan (copies distributed). Debra
asked for feedback from the MMAHB on the new transition plan.
She explained that while the national Strategic Plan and
Accountability Framework are final, the community focus teams
concept is flexible and the organizational structure can be
modified but national standardization on language and
groupings remains important. The discussion covered such
topics as tripartite relations, regional advisory structures,
alignment of national and regional organizational structures,
roles of Community Development and Liaison Officers and the
AANDC model of community focused teams, evaluating as we
implement the transition plan, transfer and long term role of
FNIHB, impact of the recognition of Non-Status
Aboriginals/Metis, impact of the Qalipu creation on NIHB,
FNIHB’s loss of contribution agreement expertise, and 2013-14
cash flow schedules.
Action Item #5: The MMAHB
Chiefs agreed to provide their
questions and comments on
the Transition Plan to Debra by
January 31, 2013 and agreed
to turn around a response in
three weeks.
8. Report on
Addictions Meetings
to the MMAHB
Gerald Gloade from UNSI presented on addictions and mental
wellness data from the Regional Health Survey (RHS). Janet
Rhymes reviewed her 2 written reports from the last 2 special
MMAHB sessions on addictions.
Action Item #6: Amanda will
investigate how to obtain an
Atlantic RHS report with narrative.
26
Agenda Items
Notes
Decision: The MMAHB instructed the Mental Wellness
Committee to use the RHS Phase 2 data and the reports
form the two MMAHB special sessions on addictions to
inform the development of a Mental Health and Addictions
strategic action plan.
Actions
Decision: The MMAHB unanimously requested a report on
Atlantic region RHS data complete with narrative. Motion:
Chief Andrea; Second: Chief Brian.
9. AAEDIRP
Research Project –
Addictions and
Economic
Development in
Atlantic Aboriginal
Communities
Amanda spoke of an APC project investigating the economic
impacts of illicit and prescription drug abuse in Atlantic First
Nations communities. She asked the MMAHB if it would support
the project’s researchers accessing NIHB data from FNIHB.
The data would not identify individuals or communities, but
rather be aggregated to the Atlantic regional level. Amanda
noted that the research had to pass the Mikmaq Ethics Watch
and Dalhousie University ethics processes.
Decision: The MMAHB unanimously agreed to allow the
researchers access to NIHB aggregated data for the above
stated purpose.
10. Closing
Chief Brian stated that the next MMAHB meeting is a special
session on Health Information Management on March 5-6 in
Halifax. This is followed by a regular MMAHB meeting on May
14-15 in Moncton.
Chief Brian stated that the selection of a FN MMAHB Co-Chair
will be done through email and phone calls between the regular
meetings to ensure that all FN voting members participate in the
decision.
27
Action #7: Amanda will send
an email to the MMAHB FN
voting members about
nominations for a FN co-chair
of MMAHB.
28
Summary Report:
Addictions in Atlantic First Nations Communities: Strengths, Gaps
and Opportunities for Action
By: Janet Rhymes
Overview
This is a summary of two meetings of First Nations Treatment Centre and Native
Alcohol and
Drug Abuse Counselling Association of Nova Scotia (NADACA) program staff, Atlantic
First
Nations Chiefs, health staff and First Nations and Inuit Health Atlantic Region (FNIHB)
staff
on the topic of drug and alcohol addiction in First Nations communities.
Meeting 1 was held Friday, October 19 in Cole Harbour Nova Scotia. This meeting
included
presentations from treatment centre staff to enhance understanding of NADACA
programs,
services and philosophies. Regional Health Survey data on addictions and mental
health
were shared. Participants collectively identified the strengths available in combating
addiction, the severity of the issue, and challenges and gaps in addressing it. Some
potential
action steps for moving forward were shared.
Due to time limitations and the scope of the topic, a second meeting to identify and
agree
upon actions was requested by the MMAHB Chiefs. This meeting was held on Tuesday,
November 20, 2012 (evening) during the November Atlantic First Nations Health
Conference
in Moncton, New Brunswick. This meeting was a continuation of the discussion and
sharing
held October 19th. In addition, comments from the attending public were welcomed if it
further informed or enhanced the content shared.
This report summarizes the discussions held at these two meetings and provides
starting
points for further action. The meeting information is provided in three sections:
1. Overview of Regional Health Survey data
2. Atlantic Treatment Centre contacts and links
3. Participant observations and suggested actions. This includes general observations
and actions, as well as observations and actions within four areas: prevention,
enforcement, supports/services and harm reduction.
29
1. Regional Health Survey Presentation Summary
Drugs and alcohol:
Youth (12-17)
- Increase in male binge drinking
- Youth not seeking help (the numbers for those who sought help are too small to
report)
- Youth see alcohol and drug addiction as "the biggest challenge facing their
community" and do not feel they are seeing any change in this
Adults (18+)
- Stats available on binge drinking weekly and month--both rates are of concern
- Highest use levels for cannabis, sedatives and opioids
- High rates of problem gambling; majority not seeking treatment
Mental health:
Youth
-
Low percentage of youth identifying as in poor mental health; very few youth with
poor mental health seek counselling
Suicide still of concern and many affected by loss from suicide
Female youth rates of suicide contemplation higher than for young men (suicide
ideation)
Depression is an issue for youth. Depression has increased among both male
and
female youth and is higher for females than males.
Bullying is also an issue. More female youth report issues with bullying than
make
youth.
Adults
- Adults, too, are significantly affected by losses from suicide. Adults results are
similar
- to youth results.
- According to national data, the rate of adults affected by suicide in Mi'kmaq
- communities (NS) is more than double that of all First nations communities
across
- Canada
- Many adults have experienced racism
- Note: The RHS respects the OCAP principles. A formal request for the detailed
data has
- been made by MMAHB leadership, owners of the data. Published data is not yet
available to
- the public but will be available in the near future.
30
2. Atlantic Treatment Centre Presentations
-
Joe Denny, Executive Director, Native Alcohol and Drug Abuse Counselling
Association of Nova Scotia (NADACA), www.nadaca.ca
Lloyd Gould, Clinical Director, Mi'kmaw Lodge Treatment Centre, Eskasoni First
Nation, www.nadaca.ca/mikmaw-lodge.html
Leanna MacLeod, Clinical Director, Eagle's Nest Treatment Centre, Indian Brook,
http://nadaca.ca/eagles-nest.html
Rose Purdy, Community Addictions Counsellor, Acadia First Nation
Chief George Ginnish, on behalf of Cindy Ginnish, Executive Director, Rising Sun
Treatment Centre, Eel Ground First Nation, www.risingsuntreatment.ca
Joe Denny shared the history of NADACA, which began as a UNSI pilot in 1971 and
which
recently celebrating their 40th anniversary in 2011. In that time, they have expanded
programs and services in the midst of an ever-changing addictions and societal context-new
problems, individuals with multiple addictions and/or addictions beyond alcohol, and a
rise in
youth substance abuse. To meet these needs, their services have expanded,
modernized,
and have become more professional. There are NADACA counsellors on every reserve,
they
support two treatment facilities and their staff work along the addictions spectrum-prevention
and education, treatment, support and long-term recovery.
The additional presentations provided an overview of services and approaches,
including
new programs designed to address new and emerging concerns.
The presentations shared by speakers are available electronically by contacting APC
Health
staff.
3. Observations and Action Opportunities Identified
Notes:
• Participant observations and potential actions shared are not necessarily true for all
communities. All communities are different. The large group meeting format and lack
of time meant that not all participant perspectives were heard on all topics.
• For ease of reading, input shared by meeting participants was summarized and
clustered.
31
Addiction and drug abuse is at crisis point in many communities. There are
individual,
family and community impacts.
-
-
-
-
This is a “family disease”. It affects individuals, family and friends. Users are in
pain
and self-medicating. Grandparents are taking on a greater role as caregivers due
to
addiction. Children are being taken from homes. They suffer further when taken
into
off-reserve foster care. Detachment has a huge impact.
It is challenging to find a balance between supporting individuals in crisis and at
the
same time ensuring the safety of families and the community. And given the
current
and historical trauma and losses people and communities have suffered, there is
reluctance to ask individuals to leave/not have them supported in community.
This is a whole community issue. Chief and Council have a responsibility to get
rid of
drug and alcohol problems, as do other agencies and providers such as the
RCMP.
Crime is on the rise in communities as a result of addiction. Elder abuse is also
happening. People are taking advantage of/are abusing elders for money.
Addiction is a complex and growing issue and a symptom of deeper problems.
-
Addictions are the 'tip of the iceberg'--the visible part of the less visible impacts of
colonization and IRS trauma, poverty, racism, marginalization, inadequate
housing
and so on. The root of the problem is enforced dependency from the
government:
high unemployment and high welfare rates. We now need to take care of
ourselves.
All treatment centres won’t solve the problem. There are deep-rooted issues that
got
us here. We need nation-building.
- To heal, we need to get to the root of the problem. All forms of abuse need to
come
out, be heard and dealt with. Parents are sick and kids are in pain and thus
abusing
drugs and alcohol.
- The needs and scope of addiction is greater and more complex than ever before.
This includes, for example, rising rates of prescription drug abuse and use of
bath
salts in some communities.
32
-
A new piece of legislation may mean that some prescription drugs will be
cheaper.
Although needs are great, growing and evolving, the ability of NADACA to
provide
additional services is limited by lack of funding and resources. There is no core
funding for the cultural component of NADACA programs. Prevention is the most
under-funded part of NADACA programs. More investment is needed for youth
prevention. There are low salaries, few tools, and a low budget.
There are assets and strengths that provide opportunities for action
- The Seven Sacred Teachings are an asset for treatment and for people along
their healing journey. They are also being used in some communities in a variety
of ways and settings so they offers a chance for consistent education and
messaging for prevention. Keep culture (including the Seven Sacred Teachings)
and language at the foundation of addiction and healing services.
- Successful approaches used by NNADAP and NADACA are strengths with
learnings to be shared. NADACA services are culture-based and include the
Seven Sacred Teachings. There are service links between the field workers and
the treatment centres. NADACA staff are knowledgeable and experienced.
NADACA offers a range of programs--treatment programs, day programs,
community programs and prevention/education. These provide support across
the addictions spectrum and are modernizing and evolving. Life coaching is
included as part of NADACA treatment programs.
- There are many individual success stories from recovering addicts and role
models that can be used as examples of recovery for prevention and education.
- Community members, including youth and those who have experienced
addictions, need to be involved in finding solutions. Getting to the root of the
problem means Healing Lodges and healing opportunities are needed in each
community.
- Host community meetings with all partners involved, including health and justice.
- We need to support a state of positivity instead of negativity. The Grand Chief
spoke about creating a new normal and a new language. For example 'life
promotion' instead of 'suicide.' Talk about hope, vision, goals and build on that
instead of focusing on the negative. Be inspiring.
- The system does not allow Aboriginal peoples to do what works. We need to put
culture back into the system. Our strengths are community, cultural beliefs,
language and people.
- Keep looking at the big picture, not just the problem and focus on what is
working.
- Part of focusing on the big picture and getting to the root of the problem is also
taking a wholistic, multi-disciplinary approach: employment, nation-building,
empowerment, education and so on. This is true for individuals but community
transformation is also required. We need to support each other.
- A website for sharing information, tools and approaches is needed.
- FNIHB sits on a national forum and can bring best practices back to the MMAHB.
- The Chiefs need to advocate for more funding for NADACA.
33
-
Write a letter from the co-chairs to Leona Aglukkaq on the scope of drug and
alcohol addiction in the region and the need for Aboriginal specific detox and
clinical therapists in each of the treatment centres (completed).
Increase funding for addiction through federal and/or provincial partnerships.
A strategy for action on improved Mental Health and Addiction is needed. This
must be developed collaboratively, in the same way that the Child and Youth
strategy has been developed.
1. Prevention
Prevention observations
-
More of a focus is needed for prevention and yet it is an underfunded area. This
is the most underfunded part of NADACA programs.
Suggested that NADACA and NNADAP work together on prevention, including
innovation and technology and integration.
Youth have the answers but must be invited in to meetings to share and learn
what they might want and have to offer. Those most affected must be part of
developing the plan for change.
Young men, in particular, have lost their way and need to reclaim their role in our
society.
Keep in mind that some youth are struggling with FASD.
There are few role models and incentives for youth in homes and in communities.
There is a connection that is lost.
This is a symptom of a much deeper problem cause by things like dispossession
and trauma. It will take years of rebuilding to regain pride and self-esteem. We
need to listen to our kids and get to the root of the problems. Kids are abusing
because they are bored and in a lot of pain.
Prevention opportunities
-
-
More investment in youth prevention.
Use of Public Service Announcements (PSAs), technology and social media
Youth conference
Focus on youth smoking as non-traditional use of tobacco can be a gateway
Peer mentoring
Teach youth to deal with stress and anxiety by offering and engaging in more
positive options and alternatives. Make this part of the school curriculum.
We need to support a state of positivity instead of negativity. The Grand Chief
spoke about creating a new normal and a new language. For example 'life
promotion' instead of 'suicide.' Talk about hope, vision, goals and build on that
instead of focusing on the negative. Be inspiring.
Work with youth in the summertime, camps, sweat lodge, making baskets, drum
and chanting...find ways to share the culture and bring back pride in culture. The
answer is with sports, recreation, faith and spirituality. But this is not enough and
there are not enough alternatives.
34
-
-
We need to change youth thought processes.
Consider the Aboriginal Shield program (community-led, RCMP-assisted
http://www.rcmp-grc.gc.ca/aboriginal-autochtone/abo-aut-shield-boucliereng.htm) "enables Aboriginal youth to gain a sense of cultural connection and
pride, while learning to make informed healthy lifestyle choices about drug use
and related activities."
Parenting skills.
Share success stories from role models and recovering addicts.
The Seven Sacred Teachings are being used in a variety of ways in
communities. it is good to have these common messages reaching community
members from different sources.
2. Enforcement and Monitoring
Enforcement and Monitoring Observations
-
-
No one should tolerate visible drug and alcohol use/abuse in communities.
Partners from Justice and federal and provincial leaders also need to help with
this issue.
Part of what has to change is the perception of drug dealers as role models.
Need to stop the selling of drugs on reserve. Some communities have had drug
dealers removed from their community. Others are working to discourage the
drug dealers by making it impossible to sell on reserve. This can lead to
retribution. And again, given the current and historical trauma and losses people
and communities have suffered, there is reluctance to ask individuals to leave/not
have them supported in community.
We need a law to deal with drug dealers and discourage their business. We must
take their house if necessary. But we need our own laws that we can support.
Need to balance intervention and zero-tolerance with the need for in-community
and family-centred supports and services.
There is a need to address the over prescription by some doctors. Many people
are taking pills and trading or selling them.
Enforcement and Monitoring Opportunities
-
Investigate the use of drug courts
Need more individuals, peers, parents/guardians community leaders and
non Aboriginal community partners (police/RCMP, mayor/wardens) to
champion and stand against drug and alcohol abuse and drug dealing.
Spread the word within the community of the number to text/call when you
see drug deal.
Need to protect the safety of those who take a stand against drug and
alcohol misuse.
35
-
Discourage drug dealers by making it impossible to sell on reserve. Share
policies from other reserves who have taken action on drug dealers. For
example, look at the housing policies in Hobbema.
Communities and Chiefs should come together and do something about
over-prescription. Identify 'pill doctors' using NIHB data. Support
complaints through the College of Physicians and Surgeons with stories
and other advocacy approaches.
3. Services and Supports, Including Treatment
Services and Supports Observations
-
More research, services and supports are needed for prescription drug
abuse.
Treatment programs are 35 days long, but need to be longer-term for
some people. It is hard to keep youth in programs for more than 35 days
and most clients are younger in age.
There is a lack of addiction supports and resources in communities once
people leave Treatment Centres.
There are an increasing number of youth needing addiction and treatment
services, but Treatment Centres cannot serve clients under 19. The only
youth treatment centre is in Labrador.
There is no First Nations-specific detox.
There were clinical therapists in each treatment centre as part of the IRS
funding, but this funding will end in 2013. There are no core-funded
culturally safe mental health services in First Nations communities.
First Nations health workers are underpaid and overworked.
Some First Nations individuals are reluctant to use/discouraged from using
off reserve treatment centres and off-reserve addiction and mental health
services generally.
There can be stigma for those who go to AA.
Language and cultural teachings and practices, including the Seven
Sacred Teachings, are core to the effectiveness of programs and services.
Services and Support Opportunities
-
-
Safe houses are needed on reserves.
Healing Lodges in every community.
Self care opportunities and support groups are needed.
Opportunities for communities and families to honestly and in a supported
way discuss abuse and begin the healing process. Create healing spaces
where a range of services and supports are provided. People need
connections and linkages to a range of supports and services
After-care supports are needed for people who have left treatment and
return to their
36
-
home communities. This could include a network of former addicts and a
way to keep in touch with those who have gone through treatment.
Investigate the continued funding of clinical therapists in each treatment
centre as part of the IRS funding.
Integrate sports, recreation, faith, spirituality and cultural teachings and
practices, such as the Seven Sacred Teachings, smudging and prayer,
sweat lodges and traditional medicines.
Treatment Opportunities
-
A First Nations-specific detox is needed. Investigate One Connections
community detox via Grand Chief Michael Mitchell
Expand the use of day programs.
More study and support options are needed for prescription drug abuse.
4. Harm Reduction
Methadone Observations
-
-
-
-
Methadone is a synthetic opioid used as a replacement for individuals who
are opioid dependent. Methadone therapy is considered a harm reduction
approach.
Most people need treatment interventions, counselling, a recovery plan
and support to move beyond addiction. Methadone can be a helpful first
step on the road to recovery but the use of methadone alone should be
considered a last resort. People are put on methadone too readily, before
more complete options and support needs are explored. It is also hard for
many people to get off methadone, for many reasons.
An increasing number of First Nations individuals are using methadone
treatment.
Methadone is prescribed to pregnant women who are opioid dependent.
Some people feel that methadone affects the health of the unborn child
and will have negative health implications for the baby. Others caution that
the outcome should be compared with what the child would be like if the
mother continued to use drugs.
Methadone and NADACA: Methadone is a drug and people must be drugfree before attending NADACA treatment centres, which follow an
abstinence-based model. The need for people to be drug free before
going to treatment is supported by the Elders.
People are, however, able to use methadone and take part in NADACA
day programs/outpatient programs. For example, 90% of those in Rising
Sun day programs are on methadone.
NIHB and transportation barriers make it challenging for methadone users
to get their methadone treatment. NIHB pays for transportation but only for
the first 4 months of use. Childcare is also a similar barrier for those who
need to take methadone daily.
37
-
-
Suboxone is a new drug that works in a similar was to methadone. It is
easier to stop than methadone and access is easier because it is taken
every three days, not daily. It is more costly, depending on how that is
measured. Dispensing fees are high for methadone but the drug cost is
$5/month. Suboxone costs $70/week but comes in packet form (low
dispensing fee). Suboxone cannot be used when pregnant. Doctors
are reluctant to prescribe Suboxone.
There is a need to support individuals using methadone while still valuing
the abstinence-based models of treatment centres
Needle Exchange
-
Used needles from drug abuse and diabetes are also a risk due to Hep C
and AIDS. There are high rates of Hep C in the Miramichi region and in
Cape Breton.
38
Special Meeting of the Mi’kmaq Maliseet Atlantic Health Board (MMAHB)
Health Information Management for Atlantic First Nations Communities
March 5-6, 2013
Holiday Inn, Harbourview
Dartmouth Nova Scotia
Monday, March 4, 2013
PHSCD Steering Committee to Attend. Not for MMAHB
9:30 – 10:00
Welcome and Introductions
10:00 – 12:00
PHSCD Evaluation Presentation of Key Findings and Validation Exercise.
Rob Assels
12:00 – 1:00
Lunch
1:00 – 3:30
Facilitated Discussions Related to Sustainability:
What are communities doing now?
What are the next steps?
How will health status indicator data collection continue?
Health Information Management Sustainability and Health Planning
Beth Lewis
3:30 – 3:45
What to Expect from Tomorrow
3:45 – 4:00
Wrap Up and Closing
Tuesday, March 5, 2013
MMAHB to attend
9:00 – 9:30
Welcome, Introductions, and Purpose of the Meeting
9:30 – 10:15
Regional Health Survey (RHS): Data collection; community access; use
of data RHS for Nova Scotia and Newfoundland
10:15 – 10:30
Nutrition Break
10:30 – 11:15
FNIHB: Data collection/availability; community access; use of data
Regional Epidemiologist, FNIHB-AR
11:15 – 12:00
Communities: Data collection; access; use of data
39
Community representatives
12:00 – 1:00
Lunch
1:00 – 1:30
Review and Questions from the morning
1:30 – 2:45
Where Do We Want to Go?
How can communities be supported in data collection and access efforts?
How do we work together for the benefit of communities?
Group discussion
2:45 – 3:00
Nutrition Break
3:00 – 3:45
Bright Spots! Stories of success on data collection and use from
community projects
3:45 – 4:00
Review of Day One
Facilitator
Wednesday, March 6, 2013
MMAHB to Attend
Discussion Question: What are the data opportunities that can be maximized to help the Health
Advisory Committees make progress in meeting the Chiefs’ health priorities?
9:00 – 9:45
Mental Health
9:45 – 10:15
Addictions
10:15 – 10:30
Nutrition Break
10:30 – 11:15
Elder Care
11:15 – 12:00
Investing in Children and Youth
12:00 – 12:15
Wrap Up and Closing.
40
MMAHB-HIM Meeting
Holiday Inn Dartmouth
March 5-6, 2013
MMAHB Members Present
Attendees:
Representing:
Chief Aaron Sock
MAWIW
Chief Andrea Paul
CMM
Proxy Chief Noel Joe
Miawpukek
Chief Deborah
Robinson
John Paul
Amanda Peters
Chelsea Googoo
Nilan Marshall
Roseanne Sark
Margaret Jadis
Tanya Poulette
Eva Sock
Maggie Organ
Tasha Sock
Sally Johnson
Non-voting Members Present
APC/NS Co-Chair
Elaine Allison
Wagmatcook
APC
APC
APC
MMAYC Co-Chair
MCPEI
Waycobah
Tui’kn
FNIHB
FNIHB
FNIHB
APC-MCPEI Elder
Membertou
Elsipogtog
Miawpukek
Elsipogtog
UNSI
41
Jennifer MacDonald
Stacey Lewis
Barbara Broom
Beth Lewis
Jennifer RossMakhan
Agatha Hopkins
Andrealiza Belzer
Kelly Bower
Gillian Bailey
Louise Cholock
Glenda Rosborough
FNIHB
FNIHB
FNIHB
FNIHB
FNIHB
FNIHB
Gerald Gloade
UNSI
Robyn Boychuck
MMAHB members & Non-voting members absent
Chief Candice Paul
UNBI
Grand Chief Ben
Sylliboy
Chief Norman Bernard
UNSI
Janet Pothier
Chief Brian Francis
MCPEI
Sandra Musgrave
Debra Keays-White
FNIHB
Morley Googoo
Roger Augustine
AFN
Agenda Items
Day 1:
Welcome &
Introductions:
RHS: Data collection;
community access;
NS and
Newfoundland:
-
-
FNIHB
Mi’kmaq Nation
CMM
FNIHB
AFN
Notes
Amanda welcomed the group and explained the reason
behind the HIM meeting. The meeting had been in
planning stages for a long time since the Chiefs wanted
to see data collection on FN health issues.
UNSI Stats Analyst Gerald Gloade and Sally Johnson
made a presentation on the amount of data collected for
the RHS.
So far there have been 1500 surveys
completed in NS and 6 in NB. There is not enough
funding to do visit each community to collect data.
Questions arose around the area of RHS not being
available in NB. For anyone who wants more information
about the RHS in NB is to contact Peter Birney and
Sarah Rose from UNBI about RHS. The Mi’kmaq Ethics
Watch Committee keeps an eye on surveying the
communities in the Atlantic Region. NB would like to
have RHS in the NB communities not only have it in
Tobique. There was confusion about “region” means
with the RHS acronym, Sally said it’s the national office
that calls region per province. There was interest at the
table to have RHS include the entire Atlantic Region, not
42
Actions
#1: Amanda will speak to Sally
from UNSI and to UNBI about
having the RHS revisiting the
idea of having surveys to be
completed throughout the
entire Atlantic Region.
#2: Jennifer Ross-Makhan
announced if anyone wants
help on the NIHB data she is
offering any assistance.
Agenda Items
FNIHB: Data
Collection/Availability:
Glenda Rosborough
-
-
-
-
Communities: Data
collection; access;
use of data
Community
Representatives
-
Notes
just particular communities throughout the Atlantic
Region.
Any data from FNIHB can be given to the communities
on request. All the communities are open for feedback
and for help and assistance to make any changes with
the tracking tools. The dental database shows results of
how many communities’ are using the dental services.
Feedback: many people agreed saying the CBRT is not
user friendly for the communities, it is long at 57 pages
and it needs to be changed and updated.
Glenda added out of 17 communities who use the CBRT,
there are only 8 that use the tools. She added the fact it
is a new program and it will take some time to get used
to it, some communities may want to use Excel where
the tools are all set up to make it easier.
Agatha: the CBRT process is needed as it is the only
piece linked to the funding agreements. Health Canada
is looking at ways in trying to simplify the tool.
John Paul asked about the future plans of combining
FNIHB and AANDC funding agreements in the next few
years. John also added if things are complicated now
with the funding agreements it will be worse and
confusing when 2 federal departments are combined.
Discussion on who can access the communities’ data.
Glenda said the request has to come from a health
director or from a Chief. The protocol is through the
health directory only.
Elsipogtog Community: HIS came along with better
electronic medical records but the tracking tools are a
disappointment. If it the tools were better more people
would be using them. EMR is another challenge as it
requires privacy and many health center employees have
43
Actions
#3: Sally will follow up with
Eva Sock about the RHS
policies that are already
developed if Elsipogtog is
interested to use the RHS
Agenda Items
Review and Questions
from the Morning:
Notes
Actions
access to the EMR. There is a privacy policy in place but information. Sally will first
there will be a 2 day privacy and policy workshop for the
have to speak to the national
health center employees soon.
office coordinator.
- Miawpukek Community: there will be a 6 fact sheet of
data to be released soon for the Newfoundland and
Labrador communities.
- Beth Lewis created 3 charts to capture the morning
session:
1.) RHS:
- Regional – NS/NL/PEI/Tobique and NB is separate
- Different approaches depending on area/province
- Emphasis on privacy & consent
- Community projects: larger communities can have
individual reports, harder for smaller ones
- Request from community – BCR
- Next survey will include “community profiles” – housing,
food security, etc.
2.) FNIHB:
- Epi’s use data already collected for reports
- Health status reports created annually
- Communities can request their health status (from HDs)
- Epi’s can provide reports that are customized to
audience and intentions/use (HDs)
- Organizations could use this data – liaise with provinces,
etc. Current protocol is request from HDs
- Watchful of impact of AANDC-FNIHB Fas
3.) Communities:
- Data sharing and provinces is technically easy but takes
time due to privacy, etc.
- OCAP followed communities’ own reports
- “Epi-boot camp” to develop capacity beyond data entry
- Health bulletins provide snap shop info to support health
44
Agenda Items
Notes
-
Where do we want to
go?
-
-
Bright Spots!
-
-
planning
Integrate indicators into health plan
Extend EMR to other programs
Sharing with other communities (privacy, EMR work,
etc).
HIM team in community
Communities need to tell their story
Many people/organizations are interested in the
collection of the RHS data. Harvard University is looking
into reviewing RHS.
Discussion around including NB to be added into the
RHS data: discussion around the gaps and problems
linked from the provinces and the communities.
Leadership in the Atlantic have to stand up and work
together in order for the RHS to work out completely
throughout the region and to include all Atlantic
provinces’ communities.
Many people agreed the communities need to benefit
from data collection but funding for better technology is
also needed.
Some ideas about technology around the table were:
connecting with Apple and using their Icloud program for
health centers’ and communities to share the data.
Elsipogtog Health Center: now have privacy policies in
place; working group committee created; more
communications with the Province Commissioner;
retrieving info from the EMR to find gaps and pieces to
work with the hospitals; training with physicians is
creating a better working relationship; 2 year
accreditation on data collection is in the works.
Tui’kn: had created an awesome fact sheet and it will be
posted on the Tui’kn website as well as the website of
45
Actions
#4: UNBI was not present at
the meeting and they hold the
RHS funding in NB therefore
this issue will be tabled at the
next MMAHB meeting.
Agenda Items
Notes
the DHA.
Miawpukek: Circle Project about diabetes has been
completed and the annual report will be given to the
Chiefs and communities (a collection of data for yearend
accumulation.
- Chief Andrea suggested that our communities’ have teen
help centers to promote healthy living and to practice
safe sex. Sally said HON is available to host workshops
on anything requested.
- Facilitator Beth Lewis created 2 posters:
Where do we want to go?:
- Pursue core funding (critical during this stage).
- Build provincial relationships.
- Unify RHS/REES- region-province-community.
- Using/reading results workshop for communities (FNIHB,
RHS, communities).
- Get ahead of the tech curve (instead of always catching
up).
- Maximize use of EPI’s and directed by a MMAHB
subgroup.
- Legal and tech expertise is needed.
Communities BRIGHT SPOTS:
- Data sharing & provinces is technically easy but takes
time due to privacy, etc.
- OCAP followed communities’ own reports.
- “Epi-boot camp” to develop capacity beyond data entry
- Health bulletins provide “snap shot” info to support health
planning.
- Integrate indicators into health plan.
- Extend EMR to other programs (HDs).
- Sharing with other communities (privacy, EMR work,
etc).
Actions
-
Review of Day One:
46
#5: John Paul suggested for
the MMAHB to have a working
group with information about
data collection (RHS data,
NIHB data and real time data).
Agenda Items
Day 2: Beth Lewis
(FNIHB Facilitator
made charts on the 4
Health Priorities of the
Chiefs:
Mental Health:
-
-


-
Notes
HIM Team in community.
Communities need to tell their story.
Discussion Question: What are the data
opportunities that can be maximized to help the
Health Advisory Committees make progress in
meeting the Chiefs’ health priorities?
Robyn Boychuck, FNIHB Policy Analyst: gave an
overview on how the MMAHB works and as the decision
maker.
Poor quality indicators in CBRT for MH (mainly referrals)
– not health status. Not NNADAP, province, etc.
RHS better source of information
Referral forms would be better source (de-identified) (no
access by EPI’s)
NEED QUALITY/SOURCES OF MH HEALTH STATUS
DATA
Mental health and/or addictions tracking tools for data at
the community level
Can nurses use “Sassi” (mental health centers) and
distribute to HD’s and discuss
Won’t be able to get information on all MH referrals
(province, etc.) could access some through the data.
Tools/forms need to be shared
Most data collected for MH&A is on paper
National project to use ‘AMI’ – elec? Database for MH&A
– links to CBRT and to EMR?
Maximize use of RHS (share with MW committee)
MTRS/NIHB data as a source for MH&A data
Anti-depressants data from (NIHB)
HSIF/AHTF project reports
IRS data (not in CBRT)
Aboriginal Healing Foundation
47
Actions
#6: Actions for mental
wellness health:
Look at RHAs/hospitals for
more data or look at data by
postal code.
Delivering mental health
counselling in the community
– there is no tracking tool at
this moment. Eskasoni
mental health and social work
have a tracking tool.
Gerald offered if anything is
needed from RHS.
Kelly added the idea to
develop a mental wellness
tracking tool
#7: Sally will bring the RHS
regional results to the MH
committee meeting in April.
Agenda Items
Addictions:
Notes
-
Elder Care:
-
LHS data
Mental wellness teams
Infant mental health (keep on?)
Not data sources but tells a story
Prescribing review & working with doctors based on
rates.
Any kind of data collected needs to have permission by
the Chiefs (for involvement about what is going on)
For each committee and work plans, how do we support
the Chiefs, Chief Andrea loves the Tuikn fact sheet –
wants to see the results and actions first hand
All Chief and Council need to be included in the work to
ensure the support (mental wellness committee
communication and community leadership – beyond the
health center – all communities to communities
Improve communications from the committees work to
the communities (especially the leadership)
NNADAP data has lots of potential (try to find ways for
reporting back to the communities – conflict in
confidentiality?)
Drug use strategy – maximize community access to
NIHB data.
Gathering to share success of addictions projects
Reports that come to FNIHB
MW committee to review possibilities of NNADAP data
Linkages back to prevention
Maternal drug use (babies born to a mother using) data
from MCH data but linkages back to MS like: C&Y,
FASD, AHSOR, family services and education
Other ways of knowing – ensuring that information isn’t
lost just because its’ not data
Data around rejected claims/pharmacy follow up on “non48
Actions
Agenda Items
-
Children & Youth:
-
Notes
benefit” Rx – NIHB data analysis
Patient/client navigators (one in CB and one in HRM) –
band paid. Data?: RHS to report on access for elders,
request from PHPC committee (CB gets stats each year;
CB can share with communities).
Long term care stats? CMM/AADNC
data/NS/NL/PEI/NB
CBRT? X
eSDRT – include data on elders who need long term
care
Adult protection data (have to go to hospital before
province AP comes in) – Prov records? Can communities
access?
IRS data to show how elders are
Falls-causes – Data?
Benzos/opiods use in elders
School data
Teen health centre data
Mi’kmaq Family data
Youth treatment (CJ Andrews and Quebec) – MTRS:
travel
Children with disabilities, data: proxy – NIHB: wheelchairs
and medications, etc.
Respite care
Development delay/screening and on mat/ch tracking tool
Childhood obesity (who) on mat/ch tracking tool
Hearing and speech screening – follow up data
FN school worker for off rez schools – data on cases
Autism data – there is this traced? Increases related to
ADHD or FASD?
Cultural interventions data of ceremonies, etc with
49
Actions
-
children & youth
Children in care: AANDC included in HSR (linked to?)
It takes a community to raise a child
COHI-children’s oral health initiative
Specific data/indicators to focus on prevention initiatives:
analysis, telling the story of the children and youth
Proactive measures for children and youth – data at
community level – CBRT
Sharing of data between C&Y departments in the
communities like: daycare, AHSOR, MCH, etc.
IWK Choices – NIHB Data like travel
RHS/REES data
Sally suggested once we get all this data from the C&Y
what are the next steps, what are we going to do with all
this information?
Closing: There was a roundtable at the end of the meeting where everyone had a chance to speak about the 2
day HIM-MMAHB meeting.
50
Health Tech’s Agenda
June 18, 2012
Crowne Plaza, Moncton NB
Welcome and Opening Prayer
Review of Agenda
Review and approval of minutes. Review of Action Items
Roundtable
New Business
 Review the MMAHB Agenda
 Review Committee Reports to MMAHB
 Update on MMAHB Evaluation, Orientation Manual, etc.
 Update on issues associated with Health Canada funding cuts
Funding cuts implications-action plan
Closing
51
Health Techs Meeting
Crowne Plaza Hotel, NB
June 18, 2012
Attendees:
Sally Johnson
Loraine Etter
Roseanne Sark
Peter Birney
Janet Pothier
Amanda Peters
Chelsea Googoo
Regrets: Laurie Nicholas
1.) Welcome and Opening Prayer: Amanda Peters welcomed the health techs to
the meeting and there was no opening prayer as Sally Johnson did an opening
prayer for the co-chairs during the morning meeting.
2.) Review of Agenda: Agenda has been approved by consensus by the health
techs.
3.) Review and approval of minutes. Review of Action Items:
Review and Approval of March 21 Minutes…review of action items: No minutes to
review since none were taken.
Note: Under new business agenda item: Peter will add the FNIHB Strategies.
4.) Roundtable:
Sally Johnson, UNSI:
Sally attended the national health technicians meeting in Ottawa, Ontario during the
week of June 11-15, 2012. She met with Valerie Gideon and they discussed the
national cutbacks. Both Paqtn’kek and Pictou Landing are now sharing a psychologist
and the province of NS is covering the financial costs. UNSI is in the middle of hiring a
52
REES Coordinator and a Data Analyst. Sally spoke to elder John Joe Sark about her
concerns with the federal cutbacks since now is only the first wave she wants the
leadership to play a bigger role, especially in the health areas. In Ontario the tribal
organizations are now being asked to show in detail about the 10% administration fee.
Sally said we have to look at the programs there are going to sunset, many in 2015.
Action Item #1: Sally will send Chelsea the document called, on the Public Health
pilot project and another link to a science class, and email it to the health techs.
Roseanne Sark, MCPEI:
Roseanne brought hard copies of her health tech update to the meeting. See her report
for more information on her latest set of meetings.
Peter Birney, UNBI:
Peter brought hard copies of his health tech update on the following areas:
-
National Issues through the restructuring of AFN and the Mental Wellness
update.
Provincial/Regional issues around HSIF, CDC Workshops, NB FN Provincial
Health Advisory Committee, NB Environmental Health Working Group and the
methadone maintenance, counseling and impact assessment.
Janet Pothier, CMM:
Janet gave an update on the NS provincial update with the possible changes to the
pharmacy association not to make direct payments to the government for the pharmacy
medical drugs and the deadline of negotiations is July 1, 2012. If the negotiations stop
then FN people will have to pay out of their own pockets for the pharmacy medical
drugs and wait for a reimbursement by Health Canada.
Janet’s idea is to utilize the Upper government level of the Opposition (NDP) so they will
know and they will question the Conservatives party during Question Period.
Action Item #2: Roseanne’s suggestion is to have a special health tech meeting
and bring the right people to the table, including the MMAHB Chiefs and Amanda,
using their own T.O. money. Action for Amanda: to look into the available funds
to host a health tech meeting. The meeting is to lay down strategies around the
idea to integrate with the Chiefs regarding the health policy areas on the federal
cut backs.
5.) New Business:
Amanda Peters - Update on MMAHB Evaluation, Orientation Manual:
53
Amanda received some feedback from a few health techs on the new NIHB committee’s
TOR. Chief Darlene Bernard will bring up the issue for discussion questions during the
MMAHB meeting on June 19. If they are approved, then they (Amanda and Robyn) will
re-write the TOR for the other MMAHB subcommittees. There was discussion around
the possibility of the provincial integration, but the health techs said it should not be
done through the MMAHB level. The Orientation Manual will look more like a how-to
guide. With the budget cutbacks, the subcommittee meetings may have to take place
during a teleconference meeting only.
The new MMAHB will look like: having 7 members: Debra Keays-White and 6 Chiefs, 1
FNIHB director and their non-voting policy support. The entire cycle will work much
better: subcommittees first meet then the MMAHB then the health directors x 3 times a
year. The meetings will be known ahead of time. There will be a template package for
each person as well. The health techs will be the ones to nominate who they want to sit
as a rep for each subcommittee.
Discussion around the MMAHB newsletter, many feel it is a good idea and it would
serve to have better communications, since it is much needed.
Update on issues associated with Health Canada funding cuts:
Discussion around the table with the health techs about the funding cuts per
organization. Everyone is discouraged about the funding cuts.
Roseanne’s suggestion: to bring AAEDIRP people to the table to inter-connect with
AAEDIRP’s research project on health, social, economic development connections:
social determinants of health.
Closing Prayer: Sally Johnson
54
Health Technicians Agenda
October 17, 2012
APC Head Office, Dartmouth, NS
1:00pm – 4:00pm
6:30pm – 8:00pm
1:00pm - 1:15pm
Welcome and Opening Prayer
1:15pm – 1:30pm
Review of Agenda
1:30pm – 1:45pm
Review and Approval of Minutes. Review of Action Items
1:45pm – 3:15pm
Review of the MMAHB Agenda
Review Committee Reports to MMAHB
Issues for the First Nations Caucus
3:15pm – 3:45pm
New Business
3:45pm – 4:00pm
Closing
6:30pm – 8:00pm
First Nations Caucus with MMAHB Chiefs (tentative)
55
Health Techs Meeting
October 17, 2012
APC Head Office, Dartmouth, Nova Scotia
Attendees: Amanda Peters, Sally Johnson, Roseanne Sark, Chelsea Googoo
Regrets: Peter Birney, Laurie Nicholas, Janet Pothier
Agenda Items
Welcome/Opening:
Notes

Review of Agenda
Review and approval
of minutes and action
items.


Review of the MMAHB
Agenda
Review Committee
Reports to the
MMAHB
Issues for FN Caucus
New Business
FN Caucus with
MMAHB Chiefs





Amanda welcomed Roseanne and
Sally.
Passed.
Minutes have been approved.
No questions or comments on the
agenda.
The 3 reports were placed in the
Health Techs packages.
Cancelled
Cancelled
56
Actions
Review of action item
#1: to delete from
notes, Sally will
follow up.
Action Item #2: did
not happen.
Health Technicians Meeting
Membertou Trade & Convention Center
January 14, 2013
Attendees:
Representing:
Laurie Nicholas
Amanda Peters
Roseanne Sark
Janet Pothier
Chelsea Googoo
MAWIW
APC
MCPEI
CMM
APC
Regrets: Sally Johnson and Peter Birney
Agenda Items
No agenda to
review


Transition Plan

MMAHB
agenda
Closing


Notes
The health techs are to meet with the
Chiefs during the evening hours to
discuss the MMAHB agenda and any
issues to follow up on.
The health techs would like to know
which committee will house the Elder’s
strategy, some agreed that it should be
the NIHB committee to take the lead.
Amanda reviewed the transition plan
with the health techs and many
questions arose about the transition
plan.
The health techs reviewed the
MMAHB agenda.
The health techs closed the meeting
and have plans to have a Caucus
meeting with the Chiefs.
57
Actions
To be presented to
the Chiefs at the
evening First Nations
caucus
Co-Chairs Agenda
June 18, 2012
Crowne Plaza, Moncton NB
2:00pm – 4:30pm
2:00am - 2:15pm
Welcome and Opening Prayer
2:15pm – 2:30pm
Review of Agenda
2:30pm – 2:45pm
Review and Approval of Minutes. Review of Action Items
2:45pm – 3:30pm
Roundtable
3:30pm – 4:15pm
New Business
-
4:15pm – 4:30pm
Review the MMAHB Agenda
Review Committee Reports to MMAHB
Update on MMAHB Evaluation, Orientation Manual
Update on issues associated with Health Canada
funding cuts
Closing
58
Co-Chairs Meeting-Minutes
Crowne Plaza, Moncton
June 18, 2012
Attendees:
James McGrath
Amanda Peters
Sally Johnson
Susan Ross
Chelsea Googoo
Regrets: Laurie Nicholas, Janet Pothier, Charmane Kay
1.) Welcome and Opening Prayer: Sally Johnson
2.) Review/approval of agenda: passed by consensus; Breakfast at Parliament
added to the agenda by Sally Johnson
3.) Review of March 2012 Action Items/Minutes:
Action Item #1: Amanda will follow up with UNBI for the PHC & PH representative.
#1: Completed.
Action item #2: Amanda to work with Wade Were from FNIHB to get the MMAHB
in camera session for FN on the next agenda.
#2: Completed.
Action Item #3: Amanda to look into setting up a group site on the HHP website.
#3: On going.
Action Items #4: Loraine to send out email.
#4: Not completed; Amanda will follow up.
Note: Minutes are passed with the deletion of the discussion around Assisted Living
(last page).
4.) Roundtable:
59
Child & Youth Co-Chairs James McGrath & Sally Johnson:
-
Validation of the C&Y Priority Setting survey results.
Discussion and input from the committee on the core elements and outline for the
child and youth strategy.
Process for developing the child and youth strategic action plan.
FASD program funding from 2013-1015 discussion.
Status of action on MMAHB directive for the child and youth strategy.
Current issues and recommendations for MMAHB: FASD program funding issues
but the majority was with the Option #1 of status quo.
Achievements since the last meeting.
PHC Co-Chair Susan Ross:
-
Susan gave a brief update and provided copies from the last PHC subcommittee
meeting.
The quality improvement, home care framework, developed resources and many
volunteers such as the FN health techs are part of it, it will occur the last week of
September 2012.
No issues or actions taken to the MMAHB.
Action #1: Susan will send Amanda more information on the Quality
Improvement.
Amanda Peters, APC:
For consideration: TRI-HAC/AGA for the following groups: MMAHB, subcommittee cochairs and the health technicians, FN members and FNIHB to all meet for 1 day.
5.) New Business:
-
Review of the MMAHB Agenda.
Review of the committee reports to MMAHB.
Update on MMAHB Evaluation, Orientation Manual etc.
Update on issues associated with Health Canada funding cuts.
Breakfast at Parliament Hill, Sally Johnson’s FNIGC Meeting:
This meeting was to launch on the report of the RHS survey from 2009-2010. Sally
passed around the table her folder she received from the meeting.
6.) Closing: Remarks by Sally Johnson
60
Co-Chairs Agenda
October 17, 2012
APC Head Office, Dartmouth, NS
9:30am – 12:00pm
9:30am - 9:45am
Welcome and Opening Prayer
9:45am – 10:00am
Review of Agenda
10:00am – 10:30am
Review and Approval of Minutes. Review of Action Items
10:30am – 11:00am
Roundtable
11:00am – 12:15pm
New Business
-
12:15pm – 1:00pm
Review the MMAHB Agenda
Review Committee Reports to MMAHB
Update on MMAHB Evaluation
Update on issues associated with HC funding cuts
DUPP Funding 2012-13
Federal Tobacco Control Strategy
Restructure of Co-chairs and Co-Chairs resignation
Closing and Lunch Provided
61
Co-chair Meeting
October 17, 2012
APC Head Office, Dartmouth, Nova Scotia
Attendees: James McGrath, Charmane Kay, Sally Johnson, Amanda Peters, Susan Ross.
Regrets: Laurie Nicholas and Janet Pothier
Agenda Items
Opening Prayer
Reviewing the
agenda
Reviewing the
Minutes
New Business:
Review the
MMAHB Agenda
New Business:
Review Committee
Reports to
MMAHB
(PHC & PH):
New Business:
Review Committee
Reports to
MMAHB
(Wellness):
New Business:
Notes










Actions
Sally Johnson opened the meeting
with a prayer.
Passed, no changes.
Action Item #1: Completed; Action
Item #4 from the March 2012
minutes will follow up by Amanda.
The co-chairs passed the minutes.
The co-chairs reviewed the MMAHB.
Amanda will follow up
with the action item #4
under the March 2012
minutes.
No action required for the MMAHB.
Sally asked about the EHO working
group with FNIHB.
Sally asked about the ongoing files
and concerns on the independent
study made on the Eskasoni Crisis
Center with the PHC/EHO.
Susan will follow up with
Kelvin for Sally about
the involvement with a
First Nations group on
the EHO.
Susan will contact
Kelvin via email and cc
Sally for further
information.
Charmane will send
Chelsea the IRS update
from FNIHB for a
placement in MMAHB
packages.
Chelsea will print 10


Charmane gave an overview on the
wellness update.
No action required for the MMAHB.
An audit will be provided for IRS.

James read aloud and gave an
62
Agenda Items
Review Committee
Reports to
MMAHB (C&Y):
Notes
overview on the C&Y update.
New Business:
Update on
MMAHB
Evaluation:

New Business:
Update on issues
associated with
HC funding cuts.
New Business:
DUPP Funding
2012-13

New Business:
Federal Tobacco
Control Strategy

Amanda discussed the MMAHB
membership letter and it will be going
out the following week to the Chiefs
and the health techs as per tribal
organization.
This item will be
Note: this will be removed from the
removed from the
agenda
agenda.


New Business:
Restructure of CoChairs & CoChairs resignation
Closing Remarks:
Actions
copies in color of the
C&Y Strategic Plan for
the MMAHB to review
on Oct 18/19.
Amanda and/or Chelsea
will be sending out the
MMAHB membership
letter the week of
October 22-26, 2012.


This DUPP decision went to a vote to
the MMAHB. The RFP will go to the
wellness committee via
teleconference on Oct. 22 for more
discussion, its’ for $184,000.
This strategy will go to the tribal
organizations instead of the
communities.
The last strategy meeting was a
success and it had a good turn out
by representatives from the tribal
organizations and from FNIHB.
Amanda previously discussed this
agenda while discussing the MMAHB
membership.
Amanda Peters closed the meeting.
63
Co-chairs Meeting
Membertou Trade & Convention Center
January 14, 2013
Attendees:
Representing:
Louise Cholock
Leila Gillis
Roseanne Sark
Janet Pothier
Chelsea Googoo
FNIHB
FNIHB
MCPEI
CMM
APC
Regrets: Gillian Bailey and Sally Johnson
Agenda Items
Opening
Prayer
Co-chairs
report: Mental
Wellness






Co-chairs
Report: Public
Health and
Primary Care


Notes
Roseanne Sark
The co-chairs of the mental wellness
committee are Gillian Bailey from FNIHB
and Janet Pothier from CMM.
Issue: DUPP funding for 2102-2013 will
be addressed to the MMAHB.
Work plan in progress and will be
completed before the MMAHB meets in
May 2013.
Recommendation for MMAHB: to have a
Gathering in the new fiscal year of 2013,
funding will come from the DUPP.
The co-chairs will present to the RAPC in
seeking a permanent observer to sit on
the mental wellness committee table.
The co-chairs are Leila Gillis and
Roseanne Sark.
The work plan is in progress and will be
completed before the MMAHB meets in
May 2013.
64
Actions
Agenda Items

Co-chairs
Report:
NIHB




Review of the
MMAHB
Agenda:
Closing:


Notes
Issue: which committee should house the
Elder’s care strategy?
The co-chairs are Louise Cholock and
Sally Johnson.
The work plan is in progress and will be
completed before the MMAHB meets in
May 2013.
Issue: which committee should house the
Elder’s Care Strategy?
The elder care working group would like
to host an Elder’s Conference possibly in
June (pending on funding).
The MMAHB Coordinator read the
agenda to the co-chairs. There were no
copies to distribute.
The co-chairs closed the meeting for
lunch.
65
Actions
PHC&PH Meeting
May 8, 2012
MCPEI Boardroom
Summerside ,PEI
Draft Agenda Topics
May 8,2012
9:00 am
Opening Prayer
Welcome and Opening Remarks
Review and Approval Agenda
Review/approval Minutes
Follow up actions, Updates (all)
1030 am
Break
1045 am
Updates (all)
12:00 pm
Lunch
1:00 pm
MCPEI Update and PEI tripartite activities– Rosanne
Sark
1:30 pm
HAC evaluation update- Amanda Peters
1:45 pm
PH/PHC workplan
2:30 pm
Break
2:45 pm
Communication Plan
3:30 pm
Input for PHC & PH Subcommittee Report for next
MMHAB meeting(June 19/12) – Co-chairs, Susan and
Laurie
3:45 pm
Closing Prayer
66
PHC & PH Committee Meeting
May 8, 2012
MCPEI Office, Summerside, PEI
Attendees:
Laurie Nicholas, MAWIW; Co-chair
Susan Ross, FNIHB; Co-chair
Leila Gillis, FNIHB
Kelvin Latham, FNIHB
Roseanne Sark , MCPEI
Loraine Etter, APC
Elaine Wilson, FNIHB; Observer
Linda McCallum, FNIHB
Paula Robinson, APC; Observer
Chelsea Googoo, APC
Elaina Bigras, UNBI
Jacki MacDonald, FNIHB
Regrets: Brenda Roos, Janet Pothier, Elaine Allison, Gillian Bailey.
1.) Opening Prayer: Roseanne Sark
2.) Welcome and Opening Remarks: Co-chairs Laurie Nicholas and Susan Ross
3.) Review and approval agenda: approved by consensus.
4.) Review/approval Minutes: Minutes have been approved by Roseanne Sark and
seconded by Jacki MacDonald
5.) Follow up actions, Updates (all):
-
Completed.
In progress.
Jacki follow up
Completed.
67
-
Completed.
Follow up with Amanda for the next meeting.
Action Item #1: Laurie will follow up with Matthew Pryde on a report he presented
on at a previous meeting.
6.) Updates (All):
Kelvin Latham:
Kelvin has been doing radon testing in some communities. In some cases, more
equipment has been put in a few communities in NB. Kelvin does monthly visits to the
communities and people can call him to ask him questions anytime.
Action Item #2: Laurie asked Kelvin about how many communities are affected
with high radon levels, Kelvin will follow up.
Action Item #3: Chelsea will send Kelvin’s update electronically to Roseanne.
Leila Gillis:
Leila’s update: see hard copy for more information. It is National Nurses Week. The
RFP for the Nurses Conference will go out before the end of May. The conference will
most likely be held in Moncton, NB. Sept. 17-20 workshops week, targeted audience will
be nurses and health directors from NB.
Action Item #4: Leila will ask Brenda Roos to forward some document to Laurie,
will ask Laurie.
7.) MCPEI Update and PEI Tripartite activities – Roseanne Sark:
Roseanne asked for the PEI communities to have their own electronic medical records.
Roseanne said the communities are asking about it, they want to manage their own
data.
PE’s HSIF projects have been approved and are just waiting for the contribution
agreements. There is concern that without the capacity dollars FN people would not be
able to attend the projects meetings as they don’t have the travel budget. Therefore
there is a further concern that the projects will look like a provincial/federally driven
project.
Note: Louise Cholock called in via teleconference and provided the NIHB update from
FNIHB. Note: to provide the best and the most accurate NIHB update, Louise’s update
has been copy/pasted to this document:
NIHB update for PHC and PH HAC May 8th, 2012
Pharmacy:
68
a) One new topic is the availability of new smoking cessation documents -posters,
checklists re readiness to quit, and listings of the drug products that are available
on the NIHB Drug Benefit List (DBL). These were developed as joint venture with
First Nations and CADTH (Canadian Agency for Drugs and Technologies in
Health). Lots of copies available in Regional office for distribution. If you have
ideas for distribution methods that could be helpful- we are planning to mail out a
package to each community.
Kathleen is also planning on doing a videoconference on the topic on May 17th.
B) Please be advised that effective May 7th, 2012 (yesterday) , Levemir insulin
(insulin determir) is an open benefit in the Non-Insured Health Benefits Program.
Levemir is a long acting insulin which is similar to Lantus insulin. Lantus is also
available as an open benefit.
C) Effective Monday March 12th, Methadone became a limited use (LU) benefit
in Nova Scotia, PEI and Newfoundland/Labrador (previously an open benefit). You may
recall we made this change in New Brunswick back in August. The main LU criterion is
for clients to be restricted to one prescribing doctor for methadone and all other opioids
and benzos. For now, this will only affect new clients starting on methadone. Clients
already on methadone will continue to have uninterrupted coverage. “NIHB clients
already receiving methadone for opioid dependence prior to March 12, 2012, will be
grandfathered as to not interrupt their methadone maintenance therapy. However, the
NIHB Program will work with the client’s treating physician and pharmacist to ensure
they meet these new LU criteria within an appropriate time frame”
d) Therapeutic Formularies (note sent to the HD’s May 4th and also sent to Susan
Ross and Marc Beaudry for distribution to HCC nurses)
These color-coded "therapeutic formularies", indicate which drugs:
 are available as open benefits, (green)
 require the pharmacy to call the Drug Exception Center, (yellow)
 require the client to go directly through the appeals procedure, (orange)
 are exclusions of the program and not subject to appeal (red)
The treatment areas addressed in the documents attached are:
 diabetes
 GI reflux disease (e.g. heartburn, other stomach problems)
 depression
 lung diseases (asthma, Chronic Obstructive Pulmonary Disease -COPD)
 osteoarthritis
 rheumatoid arthritis
Medical Transportation:
69
a) Due to misinterpretation of the Medical Transportation Policy Framework by
the Regional Office, there has been a change in the medical transportation
benefit.
Effective April 30, 2012 NIHB will cover the most economical and efficient means
of transportation, taking into consideration the urgency of the situation and the
client's medical condition. If a client chooses to travel by private vehicle (either
drive themselves or have someone else drive), the client will be approved for
mileage when this is the most economical mode. Meals and accommodations for
the client only will be covered if specific criteria are met. Meals and
Accommodations will not be covered for the driver.
A Non-Medical Escort will only be approved if specific criteria are met. The NonMedical Escort is required to stay in the same room as the client. Meals would
be covered for the Non-Medical Escort (if approved).
(a memo to clarify this was sent out to HD, Navigators and medical
Transportation workers in the community April 27th, 2012)
b) Elder Care working group update: have supported the development of a tool
or lens to review programs to make sure the programs are supportive for
Elders. MT was the first program to be reviewed. Just finalizing the work and
recommendations from the review. Still need to be discussed at RLT May
11th, 2012, with MMAHB ( and HACS) and All Chiefs
Vision:
Working on Vision Provider Kit and info sheet for clients (March 31,2013)
Medical Supplies and Equipment:
Looking to streamline processes:
a) Orthotics project Sept 2012
b) Work with QC NIHB program and their RN to review specific benefit areas
such as dressings
Note: Continued updates:
Elaina Bigras:
Elaina is discouraged to hear about the cancellation of the Health Careers for this
summer. Kevin Ryan had recently informed Elaina that the National Health Careers
have been cut. Larry Whiteduck from AFN has been laid off. Home care needs
assessment, at the community level, give nurses the skills and the tools, instead of the
politics on the reserve always plays a big role, FNIHB needs to crack down on a stricter
policy. There is a new Home Care nurse in St. Mary’s.
Paula Robinson:
Diabetes drugs and new benefits have been recently approved. Busy with incoming
calls.
70
Action Item #5: Susan will take back to Louise, the question regarding on Qalipu
and Bill C-3 clients information. (Susan please add the information/question to
this action item).
8.) HAC evaluation update – Amanda Peters:
Amanda Peters: HAC evaluation: Major funding cuts at APC’s health department, the
status of the Health Conference, the Health Directors meetings and the MMAHB is
unknown. The MMAHB evaluation is on hold for now. The Orientation Manual is on
hold as well. The child and youth strategy is being developed, including a survey (which
is going live tomorrow). The survey is online and it takes 20 minutes to take, Amanda is
encouraging everyone to use it. The MMAHB is held on June 19 in Moncton at the
Crowne Plaza.
Action Item #6: Chelsea will email the letter to the Minister of Health and the
Media Release written by John Paul.
Linda McCallum Update (Update is provided in hard copy)
Loraine Etter Update (Update is provided in hard copy)
Laurie Nicholas Update (Update is provided)
Roseanne Sark (Update is provided)
Susan Ross (Update is provided)
9.) PHC/PH work plan:
The work plan is on hold for now, will revisit at the next meeting.
10.)
Communication Plan:
Communication Plan discussion around the following action item:
Roseanne wants to know the process of how to get on to the MMAHB agenda as a
committee.
11.)
Input for PHC & PH Subcomittee report for the next MMAHB meeting:
Action Item #7: The co-chairs requested for the committee members to send them
all the most important topics for the PHC committee’s report to the MMAHB.
12.)
Closing Prayer: Roseanne Sark
71
PHC & PH Committee Meeting
September 5, 2012
APC Office, Cole Harbor, N.S.
9:00 a.m.
Opening Prayer
Welcome and Opening Remarks
Review and Approval of Agenda
Review/approval Minutes
Follow up actions/read updates
10:30 a.m.
Break
10:45 a.m.
HAC Evaluation update – Amanda Peters
11:30 a.m.
Questions on the updates – all
12:00 p.m.
Lunch
1:00 p.m.
Tobacco Control Strategy
1:15 p.m.
PHC/PH communication plan
2:30 p.m.
Break
2:45 p.m.
Input for PHC & PH subcommittee report for the next
MMAHB meeting (September 19, 2012) – Co-chair, Laurie
Nicholas
3:30 p.m.
Closing Prayer
72
Primary Health Care/Public Health Committee
September 5, 2012
APC Head Office, Dartmouth, Nova Scotia
Attendees: Laurie Nicholas, Susan Ross, Elaina Bigras, Linda MacCullum, Jackie MacDonald,
Rosanne Sark, Elaine Allison, Brenda Roos, Amanda Peters, Chelsea Googoo, Janna McKay
Agenda Items
1. Opening Prayer /
Welcome and
Introductions
2. Review and
Approval of the
Agenda
3. Review and
Approval of Minutes
4. Review of Action
Items
5. MMAHB
Evaluation Update –
Amanda Peters
Notes
Prayer opened with Roseanne Sark
Agenda changed from 12-12:30 for lunch.
Agenda has been approved but with the
changes by the committee.
Minutes approved by Linda, seconded by
Roseanne.
#1. Not completed.
#2. Not completed.
#3. Follow up.
#4. Completed.
#5. Completed.
#6. Completed.
#7. Not completed.
Amanda briefly spoke about the MMAHB update
about the Health Directors document. This was
created by Amanda because many health
directors felt they were not receiving APC health
updates. Amanda presented the Draft version
of the new TOR for the MMAHB and the
subcommittees. She explained the new
changes if approved by the MMAHB. Lots of
discussion around the TOR by the committee
members.
73
Actions
Agenda Items
6. Updates from the
Committee and
Questions
7. Tobacco Control
Strategy
Notes
Many committee members asked Amanda
questions on the proposed TOR. She did clarify
much of the information.
Heather MacDonald provided an update in hard
copy. Louis Devon is the lead on Tobacco
Control Strategy at the HQ office. The funding
that will be given to the communities maybe
given by clustering. A recommendation will go
to the MMAHB for a final decision.
8. PH/PHC
Communications
Plan
The committee discussed various ways that
communications could be improved under the
new MMAHB assuming it is approved at
MMAHB:
 There is a gap with AFN.
 Health Canada needs to understand how
the tribal organizations work and what
their structure is.
 There is often no one to communicate at
Health Canada (while the individual is on
vacation for example) then who is in the
next chain of command to contact?
 Recommended that we look at other
T.O.’s across Canada and see how their
techs work on their committees, look at
the successes and the failures. Also,
how can we look at traditional knowledge
and incorporate it into our HAC’s and
MMAHB.
 Communication will work better if all
committee members all trust one
another.
 Why are there no Heath Technician
proxies if they cannot show up to a
committee meeting?
Louise had sent her update. Many of the NIHB
appeals and approvals will have to be made by
HQ in Ottawa. Discussion over vaccinations
that are not covered under NIHB.
 Committee is wondering why certain
ones have not been covered. I.e. TwinRx
Discussion on Nurse Authorization Numbers for
Supplies
 Need physician approval and
prescription. Nurses cannot order
supplies and the communities are
carrying the costs when supplies are
9. NIHB Update –
Louise Cholock via
telephone
74
Actions
A1: Chelsea will send
the speaking notes
on the PP to the
committee members.
A2: Amanda will send
out Heather’s contact
information to the
committee members.
A3: Laurie is
requesting to have
the roles of the dental
therapist and
consultant be
provided for the
health techs. Louise
said she will speak to
Dr Jones about
providing a document
concerning his role at
FNIHB.
Agenda Items
Notes
needed and there is no time to wait for
NIHB.
 There is a process underway that would
allow nurses to order supplies and
hopefully that will be in place in the next
couple months.
Home Care Discussion
 All communities will be receiving laptops
for their Home Care coordinators- just
working on the distribution logistics at
present.
9. Input for the
Report to the
MMAHB
See A5
10. Closing Prayer
Elaina Bigras
Actions
A4: Elaine wants
Susan to send her
the information on
CAET, Susan will
send to the
committee.
A5: Laurie is giving
the committee
members until Sept.
12 to submit any
information to be
written up for the
PHC & PH co-chairs
report to the MMAHB.
Roseanne suggested
a bright spot to be
sent to Laurie.
75
Meeting Information
COMMITTEE: NIHB Committee
DATE: December 4-5, 2012
LOCATION: Office of First Nations and Inuit Health Branch, 1505 Barrington Street, Halifax 18th
Floor
Time
10:0010:30
10:3011:00
11:0012:00
12:00-1:00
1:00-1:30
1:30-2:30
2:30-2:45
2:45-3:15
Agenda Items
Item
Opening Prayer, Introductions and Ice Breaker
Background on MMAHB/MMAHB Evaluation
Process
Review of FNIHB Programs and Resources
9:00-9:15
Lunch
MMAHB Cycle (Planning and Communications
Scope of Decision Making
Break
Committee Membership, Activities, and
Roles/Responsibilities
Meeting Processes and Administration
Preparing for First Nations Co-chair Selection
Preparation for Day 2 Activities
Final Thoughts and Closing
DAY 2
First Nations Co-Chair Selection
9:15-12:15
Brainstorming Activities for Workplanning
3:15-3:45
3:45-3:50
3:50-4:15
4:15-4:30
Presenter
Robin Boychuk, FNIHB
Amanda Peters, APC
Wade Were, FNIHB
Amanda Peters, APC
Wade Were, FNIHB
Robin Boychuk, FNIHB
Amanda Peters, APC
Amanda Peters, APC
Robin Boychuk, FNIHB
First Nations Committee
Members
Committee. Facilitated by
FNIHB and APC Policy Staff
Notes on the Agenda
1. Documents that will be provided to you include:





Slide Show from Orientation Session
Terms of Reference for MMAHB Committees
MMAHB Evaluation Report
Contact Sheet for all members of the three (3) Committee and the MMAHB
Elder Care Strategic Plan, Mental Health and Addictions Strategic Plan, Child and Youth
Strategic Plan.
2. To prepare you may want to:
76





Review the Guiding Principles Document
(http://www.apcfnc.ca/en/health/resources/HealthPrioritiesGuidingPrinciplesFinalVersion
May2011.pdf)
Review the Terms of Reference (http://www.apcfnc.ca/en/health/mmahb.asp)
Think about items/issues that you want the committee to be working on
Please remember that First Nations and Inuit Health Branch offices are scent free and
please do not bring any foods that contain onion or garlic onto the premises.
Note that lunch will not be provided, there is a food court in the building and you will be
reimbursed at APC rates
77
NIHB Committee Meeting
FNIHB Office, Halifax
December 4 and 5, 2012
Attendees:
Voting members:
Louise Cholock
Peter Birney
Shelly McLean
Sally Johnson
Laurie Nicholas
Non-voting/Observing members:
Amanda Peters
Chelsea Googoo
Patricia Saulis
Wade Were
Geoff Lahey
Jody Tulk
Greg Jones
Jennifer Ross-Makhan
Robyn Boychuk
Kate Gray-Mews
Representing:
FNIHB
UNBI
MCPEI
UNSI
MAWIW
APC
APC
APC
FNIHB
FNIHB
FNIHB
FNIHB
FNIHB
FNIHB
FNIHB
Regrets: Janet Pothier and Linda Joe
Agenda Items
Opening Prayer,
Introductions and Ice
Breaker
Background on
MMAHB and MMAHB
Evaluation Process
Review of FNIHB

Notes
Opening Prayer: Sally Johnson
Introduction & Ice Breaker: Robyn
Boychuk & Amanda Peters
Amanda Peters provided a
background on the MMAHB
evaluation process and the
contents of the MMAHB
Orientation Package.

Wade Were reviewed the FNIHB’s


78
Actions
#1: Amanda will
send out the All
Chiefs resolution on
the MMAHB ToR to
interested
individuals of the
NIHB committee.
#2: Wade will send
Agenda Items
Programs & Services
Notes
programs and services outlined in
the attached MMAHB Committee
Orientation: FNIHB’s role,
responsibilities, portfolios and
goals. Peter Birney asked about
the role of AANDC with the
MMAHB, Amanda added that
AANDC will be sitting at the
MMAHB table as an observer.
Actions
the committee an
up to date FNIHB
staffing list.
#3: Sally suggested
adding the RHS to
#3 (Measuring
health status –
identifiers, various
owners of data) of
“Selected
Challenges we
face” part of the
MMAHB Orientation
Package.
#4: Wade to send
Laurie the 1979
Indian Health Policy
online link.
MMAHB Cycle

Scope of Decision
Making


Committee
Membership,
activities &
Roles/Responsibilities

Amanda presented a detailed
description on how the MMAHB
cycle works, when meetings take
place, and the MMAHB
communications.
Wade presented and explained a
detailed process on how decisions
are made between the FN parties
and FNIHB. There are 3 levels of
decision making: 1. Shared
Decision; 2. Funding Decision
(includes allocation); 3. Policy and
planning Decision.
Explanation and discussion on the
term co-management as different
from the financial intervention
definition commonly used in First
Nations communities.
Robyn explained the membership
between the voting members and
the non-voting members (includes
a representation from the Atlantic
tribal organizations and the FNIHB
employees). Robyn also explained
how the committee activities in
79
Agenda Items
Meeting Process and
Administration

Preparing for First
Nations and Co-Chair
selection

Preparation for Day 2
Activities

Final Thoughts and
Closing

Notes
detail as well as the roles and
responsibilities, the attendance of
the voting members and the
appointments of the co-chairs.
Amanda explained the meeting
process and administration part
behind APC (the work of the
health policy analyst & the
MMAHB Coordinator). The
process includes: deadlines of
paperwork, the logistics of the
planning of meeting dates,
locations, templates and any other
additional work provided by APC.
Amanda explained the process of
the voting of the FN co-chair. The
selected co-chair will be chosen
for the duration of 2 years.
Both Robyn and Amanda
explained that a facilitator will
attend day 2 of the meeting for
brainstorming for the NIHB work
plan.
Amanda provided a recap of the
days’ activities and what is
expected out of day 2.
Actions
The day 2 report to be provided by facilitator at a later date.
Note: After the meeting completed FNIHB Regional Director Debra Keays-White came
in to announce the staffing changes occurring at the FNIHB office. Peter MacGregor is
now the acting manager of the mental wellness programs temporarily until the manager
position is filled. Charmane Kay will continue to be part of the IRS program until the
position is filled.
80
Child and Youth Committee Meeting
Crowne Plaza, Moncton, NB
June 8th, 2012
9:00 am - 4:15 pm
AGENDA
8:45 am – 9:00 am
Arrival and Meet and Greet
9:00am – 9:05am
Welcome and Opening Prayer
Committee Co-chairs: Sally Johnson and James McGrath
9:05 am – 9:15 am
Review and approval of Agenda, Minutes From Feb 2012, and
Action Items - Committee Co-chairs: Sally Johnson and James
McGrath
9:15 am – 10:15 am
Validation of the Child and Youth Priority Setting Survey
Results – Robin Boychuk, Advisor, Policy and Strategic Planning,
FNIHB and Amanda Peters, Senior Health Policy Analyst, APC
10:15 am – 10:30 am
Nutrition & Stretch Break
10:30 am – 11:30 am
Discussion and Input From the Committee on the Core
Elements and Outline for the Child and Youth Strategic
Action Plan - Robin Boychuk, Advisor, Policy and Strategic
Planning, FNIHB and Amanda Peters, Senior Health Policy
Analyst, APC
81
11:30 am – 12:15 pm
Next Steps For The Process in Developing the Child and
Youth Strategic Action Plan - Robin Boychuk, Advisor, Policy
and Strategic Planning, FNIHB and Amanda Peters, Senior Health
Policy Analyst, APC
12:15 pm – 1:00 pm
Lunch Provided
1:00 pm – 2:30 pm
FASD Program Funding 2013-2015 – Barbara Broom, Clinical
Nurse Specialist, FNIHB
2:30 pm – 2:45 pm
Nutrition & Stretch Break
2:45 pm – 2:55 pm
General Update on MMAHB Activities - Amanda Peters, Senior
Health Policy Analyst, APC
2:55 pm – 3:15 pm
Regional Employment, Education and Early Childhood
Survey – Sally Johnson, Health Technician, UNSI
3:15 pm – 4:00 pm
First Nation Organization and FNIHB Child and Youth Program
Updates** (All) (About 5 mins/report)
** In your updates, it would be helpful if you could include the following 2 sections – (1) Upcoming C
and Y Training / Education / Workshops including dates that your organization/program may be hosting
before March 31, 2013 (2) Highlight any potential items that should be included in the MMAHB update
(i.e. C & Y subcommittee items that need MMAHB support)
4:00 pm – 4:10 pm
Review of Meeting Action Items From Recorded Minutes –
Chelsea Googoo-Brown, MMAHB Coordinator, APC
4:10 pm – 4:15 pm
Closing Remarks - Committee Co-chairs: Sally Johnson and
4:15 pm
Closing Prayer
James McGrath
82
Child & Youth Committee Meeting
June 8, 2012
Crowne Plaza
Attendees:
Philippa Pictou, CMM
James McGrath, FNIHB; Co-Chair
Margie Fowler, FNIHB
Sandra Musgrave, FNIHB
Sally Johnson, UNSI; Co-Chair
Andrealisa Belzer, FNIHB
Tammy Arsenault, MCPEI
Amanda Peters, APC
Caryn Small Legs-Nagge, FNIHB
Cheyenne Mary, FNIHB
Robin Boychuck, FNIHB
Barbara Broom, FNIHB
Pam Gough, FNIHB
Chelsea Googoo, APC
1.) Arrival and Meet & Greet: Co-chair James McGrath
2.) Welcome and Opening Prayer: Sally Johnson
3.) Review and approval of Agenda, Minutes from Feb. 2012, and Action Items:
-
Review and Approval of agenda: agenda approved by the committee.
-
Review of Minutes: approved by the committee.
-
Review of Action Items:
Action Item #1: Chelsea will resend all 4 sets of C&Y minutes to all the committee
members (completed).
83
Action Item #2: Glenda will research into the number of FN women breast feeding,
including the breakdown of the numbers per province and come back to the
committee and/or co-chairs. (Deferred until the next meeting, Andrealisa will follow
up)
Action Item #3: Barbara will send an electronic copy of the document to each
FASD/health community worker and to the C&Y committee members. (Completed:
was sent to the health community workers; not FASD workers)
4.) Validation of the C&Y Priority Setting Survey Results: Amanda Peters &
Robin Boychuck:
-
Discussion and Input from the Committee on the Core Elements and
Outline for the Child and Youth Strategic Action Plan
-
Next steps for the Process in Developing the Child and Youth Strategic
Action Plan
Robin asked for the committee to review the documents and give them 2 weeks instead
of reviewing during the morning only.
Action Item #1: C&Y committee members to contact Amanda/Robin about their
thoughts, feedback and ideas on the results of the survey within 2 weeks from
today, June 22, 2012. Robin will send a follow up email as a reminder.
List of ideas from the results of the survey:
-
Better to list the top 5, rather than the other priorities as lower priorities.
Laurie asked about the age of youth, who are the youth and what age range? Amanda
said MMAYC considers youth to be up to 25 years old. This committee will recognize
MMAYC’s age limit of 25 years old.
The MMAHB might meet the week of September 18-20, which is a week before All
Chiefs.
Laurie suggested for the community members to be provided with an executive
summary.
Culture and language seems to be one of the most important priorities among the
results as it continues to show up every time.
5.) FASD Program Funding 2013-2015 (Barbara Broom, Clinical Nurse
Specialist, FNIHB:
-
Note: Barbara provided 4 documents on the FASD funding.
84
-
Note: Caryn & Cheyenne: explained in detail about the FASD Program
population based funding distribution, (chart) regarding the FASD funding.
The First Nations members reviewed the 3 different options and voted, listed below are
the results of the vote:
-
Laurie Nicholas: status quo
Amanda Peters: status quo
Tammy Arsenault: status quo
Marie Levi: RFP (met with the Assembly of NB Chiefs on May 17, majority voted
for RFP).
Sally Johnson: status quo
Phillipa Pictou: status quo
Status quo is option #1: fund the 8 existing projects for two more years 2013-2015 and
then revisit this discussion (From FASD Funding letter from Barbara Broom).
Majority of the Tribal Organizations (T.O.’s) representatives agreed with option #1
(status quo). However this committee will revisit the decision again.
Action item #2: The FASD funding vote from the T.O.’s members will be brought
to the June 19 MMAHB meeting and the co-chairs will report the recommendation.
James asked about the decision of the T.O.’s: if this recommendation goes forward,
what do we say or what happens next? Barb suggested we say this is a consensus
vote…also looking at 2015 to better understand the funding protocol and exploring the
options for the next 2 years.
Action Item #3: Sally and Amanda to write up the FASD funding/vote
recommendation to the MMAHB.
6.) General Update on MMAHB activities, Amanda Peters:
-
Funding Cuts from the Atlantic (Valerie Gideon at All Chiefs):
-
$735,000 cuts in the Atlantic.
-
3% growth will continue in the communities.
-
UNBI, CMM, APC, received cuts in the policy and consultation areas.
-
HSIF no FN input for HSIF, however Kate Gray Meuse is working on it.
-
Health Careers were entirely cut nationally.
7.) Regional Employment, Education and Early Childhood Survey – Sall
Johnson, Health Technician, UNSI:
85
This position will be responsible for NS, PEI and NFLD. Sally is in the process of hiring
a REES Coordinator and a Statistical Data Analyst. FNIGC is funding these 2 positions
through UNSI.
Action Item #4: Sally will email Chelsea the REES Coordinator and the Statistical
Data (2 UNSI job opportunities) to forward to the C&Y members to share.
8.) First Nation Organizations and FNIHB Child & Youth Program Updates:
Sally Johnson, FNIHB:
Sally will be attending the AFN’s national health technicians for 3 days next week in
Ottawa, Ont. She also gave an update on the REES Coordinator position from UNSI.
Pam Gough, FNIHB:
Pam provided an update on hard copy. Her update includes community dental visits.
Barbara Broom, FNIHB:
Barbara provided an FASD and Injury prevention update. The PARTY (is a program) is
to get more facilitators to train more trainers to be added to this program for every grade
9 students to raise awareness.
Philippa Pictou, CMM:
Jordan’s Principle update: court case is Monday and Tuesday in Halifax. There will be
a walk starting at the Friendship Center to the Courthouse starting at 12:00pm on
Monday. The Social update with the Tripartite level, new funding for a person to look at
the services on and off reserve. This is for mapping a program with the Social Tripartite
Coordinator.
Pictou Landing recently set up a new committee for more awareness on Bathsalts.
They also had a drug information session as well as an emergency meeting. Both
Pictou Landing and Paqtn’kek now share a FN Nurse Practioner funded by the DHA of
New Glasgow.
Amanda Peters, APC:
Amanda read aloud the All Chiefs who just passed a resolution yesterday (June 7),
along with All Chiefs across Canada on the welfare of children and youth, it is being
passed nationally with all the First Nations Chiefs.
The All Chiefs also passed the MMAYC Conference resolution for each community to
pitch in $1200.00 for 2 youth and 1 IRS Survivor to attend the conference in
Fredericton, NB at UNB. The conference dates are August 6-8, 2012.
Action #5: Amanda said she will send the All Chiefs Resolution for the welfare of
FN children and youth, which is still in draft format, once its’ completed and will
forward it to the C&Y.
86
Tammy Arsenault, MCPEI:
Lennox Island is trying to set up a Radio station for the youth. The boys and girls club
will be having a golf tournament this summer on July 16, and invited Theo Fleury
(former NHL player who is Metis).
Action Item #6: James asked for all the members to send/email their member
update to Chelsea to add into the master copy and to have an electronic copy.
James McGrath, FNIHB: James submitted an update. (James can you fill in this area
regarding your update)
Action Item #7: Barbara invited Philippa to the FN C&Y: MHA meeting on July 10
at the IWK to make a presentation on the recent Bathsalts issue that had occurred
in Pictou Landing.
9.) Review of Meeting Action Items from recorded minutes – Chelsea Googoo:
Chelsea read aloud the 7 action items recorded.
10.)
Closing Remarks: Co-Chair Sally Johnson
11.)
Closing Prayer: Sally Johnson
87
Child and Youth Committee Meeting
APC Office, Cole Harbour, NS
September 7th, 2012
9:00 am - 4:00 pm
DRAFT AGENDA
8:45 am – 9:00 am
Arrival - Meet and Greet
9:00 am – 9:10 am
Welcome and Opening Prayer
Committee Co-chairs: Sally Johnson and James McGrath
9:10 am – 9:20 am
Review and approval of Agenda, Minutes From June 2012, and
Action Items - Committee Co-chairs: Sally Johnson and James
McGrath
9:20 am – 10:10 am
MMHAB Evaluation Results and Proposed MMHAB Terms of
Reference – Amanda Peters, Senior Health Policy Analyst, APC
10:10 am – 10:40 am
First Nations Tobacco Control Strategy - Amanda Peters, Senior
Health Policy Analyst, APC and/or Brenda Roos, Regional Nurse
Manager/ADI Program Manager, FNIHB
10:40 am – 11:00 am
Nutrition & Stretch Break
11:00 am – 12:15 am
MMAHB Child and Youth Strategic Action Plan - Robin Boychuk,
Advisor, Policy and Strategic Planning, FNIHB and Amanda
Peters, Senior Health Policy Analyst, APC
12:15 pm – 1:15 pm
Lunch Provided
1:15 pm – 1:25 pm
Introduction of FASD/IP Nurse Coordinator – Tracy Lovett, Nurse
Coordinator – FASD/IP, FNIHB
1:25 pm – 2:10 pm
Overview of the Children’s Oral Health Initiative (COHI) – Pam
Gough, COHI Coordinator, FNIHB
2:10 pm – 2:30 pm
Roundtable First Nation Organization and FNIHB Child and Youth
Program Updates** (All)
2:30 pm – 2:50 pm
Nutrition & Stretch Break
88
2:50 pm – 3:50 pm
Roundtable First Nation Organization and FNIHB Child and Youth
Program Updates** (All)
** In your updates, it would be helpful if you could include the following – (1) Upcoming C and Y
Training / Education / Workshops including dates that your organization/program may be hosting before
March 31, 2013 (2) Highlight any potential items that should be included in the MMAHB update (i.e. C &
Y subcommittee items that need MMAHB support)
3:50 pm – 3:55 pm
Review of Meeting Action Items From Recorded Minutes –
Chelsea Googoo-Brown, MMAHB Coordinator, APC
3:55 pm – 4:00 pm
Closing Remarks - Committee Co-chairs: Sally Johnson and James
4:00 pm
Closing Prayer
McGrath
89
Child and Youth Committee
September 7, 2012
APC Head Office, Dartmouth, Nova Scotia
Attendees: Sally Johnson, James McGrath, Barbara Broom, Cheryl Chisholm (for Margie
Fowler), Leanne Yates (For Andrealisa Belzer), Robyn Boychuk, Tammy Arsenault, Pam
Gough, Small Legs-Nagge, Philippa Pictou, John Sylliboy, Marie Levi may call in, Laurie
Nicholas
Agenda Items
1. Opening Prayer
/ Welcome and
Introductions
2. Review and
Approval of the
Agenda and
Minutes













Notes
Sally provided opening prayer and
welcoming remarks
Wade will present at 1:25 and Pam at
9:20
Agenda will be as is
Lunch is shortened for 30 min.
Meeting minutes: #8 Caryn Small Legges
provided updates as did James which
need to be included
Question on Action #2 – If this action is
to be deferred to this meeting? Answer- it
was already done. Glenda would (pg.2)
2nd paragraph under Philippa –
clarification will be provided by Philippa
Clarification also that it is not a nurse
practioner, but a mental health practioner
(also will be clarified by Philippa)
Sally suggested to review all action
items:
Chelsea’s action is completed
# 2 is done
#3 is completed
#1 for pg. 2, completed – revise typo on
90
Actions
A1: Caryn and James
will send the updates to
include in the notes
Agenda Items







3. MMAHB
Evaluation Update
– A. Peters
4. Federal First
Nations Tobacco
Strategy – B.Roos
Notes
by instead of from 22nd.
Recommendations action completed and
accepted
#4 is done
#5 Amanda is not here to see if it is
done….Sally does not recall and it was
then deferred to the next meeting
#6 James followed up, but Chelsea
needs to answer this…deferred
#7 is done. FN Health – add “network”
from Barbara
Sally suggested that there be a video to
show for the next C&Y meeting – Philippa
provided information on an APTN
interview and DVD will also be provided –
which can be shared later
Minor revisions needed but meeting
minutes are accepted
Actions
Wade Were is presenting on Amanda’s
behalf
Reviewed the ToRs for the MMAHB and the
committees that will be going to the MMAHB
for approval later in the month. Some
general discussion on how it will be
organized; how will the Child and Youth
issues be properly addressed under the new
structure? etc.
Brenda Roos presented on the Federal
Tobacco Strategy for information purposes
only. Some of the topics reviewed included:

5. Child and Youth
Strategic Plan – A.
Peters and R.
500-600K per region per year (25M for
the next five years for national)
 There was a stakeholder meeting last
week Aug. 27 hosted by APC.
Recommendations were sought for
MMAHB to best roll out the initiative. Two
options are going forward to MMAHB,
which then will be presented to All Chiefs
the following week.
 The Strategy has been quite
“prescriptive” from HQ in relation to
essential criteria lead by HQ, like call for
proposals or any roll out. There has to be
methods for data collection and
evaluation for progress and results.
Robyn gave an overview of the Strategy, survey,
expectations and general direction for
leadership, stakeholders and future next steps
91
A2: Amanda to
forward the
document to folks on
Agenda Items
Boychuk
Notes
Input is required and sought for some areas at
this table, especially for areas of who should
lead in what area: policy etc. Robyn revewied the
discussion questions





How will it be ensured that this strategic
plan will be a priority in the next
committee? Robyn suggested to bring it
up in the afternoon with Wade’s
presentation - how does this committee
envision to bringing this to another
committee? Please bring it up this
afternoon with Wade.
Robyn/Sally: the Canadian Red Cross –
AFN and there is a MOU in place that
can be a spring board to other areas for
service. There should be a reinforcement
of support for this type of agreement.
More regional orgs and tribal orgs could
follow this model for such programs as
injury prevention. This could also be used
for community health planning
Implementation: HC shares the concerns
for the implementation of measures for
the plan and its usage….what are the first
few steps of implementation? A formal
endorsement is required at the Chiefs
level.
Measuring and reporting: is there a
possibility for an annual evaluative?
There is a score card that is included in
the implementation as well. It will be
integrated to the existing reporting
requirements and processes. Will there
be a specific reporting for this. Yes, there
will be, but also in coordination with
existing reporting methodologies. Robyn:
What is realistic that could be included in
the score card that will be identified in the
logic model…
Does it outline the existing process in
place, such as Micmac family services?
Will they be informed that this strategy
exists? Will there be some sort of
communication to inform other programs
that are ongoing for child and youth
programs? There will be community staff
that would need to be informed on the
strategy as part of the implementation
92
Actions
this committee (MOU
with CRC)
A3: Robyn will add
clarification of the
score card process.
A4: Robyn will clarify
what the culture and
language piece what
Agenda Items









6. FASD/IP Nurse
Coordinator


7. Overview of
COHI – P. Gough
Notes
process
What do you mean by technology?
Robyn explained that there are various
models to contextualizing the outcomes
through models like the medicine wheel,
or other visual representation. The idea is
that this table helps to give input.
Would this be included in the following
MMAHB for endorsement? And what are
the following activities for the following
years aside from year one? This would
have to happen via consensus with First
Nations and from HC. Year one activities
could be revisited so that there is some
implementation of initial activities to start
up. Perhaps, priorities could be better
identified as next steps. Robyn assured
that there would be clarification on short
and long term outcomes in the footnotes.
There will also be a realistic and doable
evaluation plan keeping in mind that it
would not add on to existing workloads.
Laurie: the report needs to be reworded
on page 7 for culture and language. The
recommendation is to revisit that area
that clarifies the what the youth referred
to with respect to language and culture
Clarify that the reference for Atlantic
refers to the FNs, but not necessarily
representative of all, such as the Innu.
The development process should be
included and better detailed in the
document – companion documents and
background information.
Suggestion is to look at the formatting so
that it would be more read friendly and
some other visual formatting for graphs.
Robyn can take written submission right
up to Sept. 11 regarding the document.
Vague activities: Get rid of “endorse”;
Question #7 – share it now, not wait.
Committee was introduced to the new
FASD/IP Coordinator at FNIHB
Committee did introductions as well
The Children’s Oral Health Initiative (COHI)
falls under the MCH (Maternal Child Health )
program. Overview of the program was
provided by Pam Gough. Some of the issues
93
Actions
the youth had refereed
to.
Agenda Items
9. Committee
Member Updates
Notes
discussed were:
 There are 40 currently working under
various programs – like MCH workers
 There should be a master list of the who
is doing what in the services for COHI.
 What’s the plan for funding in the future?
Will this sunset? There has not be a date
established, but it seems there will be a
program evaluation in November.
 What will the services look like when
schools closed? There is a shift of
services from Dental therapists to Dental
hygienists (DTs operate only in two
provinces – Manitoba and Sask) DTs can
only work on communities but should be
working in more communities
 Vancouver college is looking into
expanding dental hygienists
responsibilities. Hygienists are selfregulated in most provinces
Sally
 FNIGC meeting is next week where they
will be discussing the REES Survey
(Regional Education, Employment and
Early Childhood Development Survey)
 How many communities are on the RHS?
13 in NS, 2 in PEI, Tobique in NB, and
Conne River for NL. UNBI does the NB,
but only completed 6 communities, which
was also to include PEI. There is a high
90+% response rate in NS. There have
been problems here and there. Once the
reporting is done, findings and concerns
will be shared.
 AFN National Health Technicians
Meeting in Ottawa – Sally will send the
agenda for people review and make
suggestions for discussion topics.
 John asked Sally if the Wabanaki Two
Spirit Alliance could attend a meeting to
help capture data respecting two-spirit
information.
MCHP:



Curriculum dates for November and
December
Video on education sessions for the next
round are: (refer to her document)
Cheyanne is still doing the circles
94
Actions
Agenda Items


Notes
NB screening tool – for community health
nurses, are they recommended to use
the same resources/guides?
What percentage of the program have
home visitors? Most of the communities
have a home visitor
COHI:
 Training session to be delivered at the
end of the month
 Indian island and Buctouche will be
delivered
 NS will be for quality assurance starting
in CB in October
 PEI for Abegweit
 Fluoride washes…none of the
communities were not reaching the goal.
The goal will be now 2 fluoride
applications.
 Do those 2 applications are the minimal
requirement. Pam says it is the scientific
requirement
Tammi:
 MCH database will be applied on for
Lennox Island
 Is it similar to the Manitoba database. It is
similar but had been adapted to their
needs.
Health Information Analysis Solutions – Ehealth
Solutions




Refer to the document that Leanne
provided
There are communities that will be
evaluated in the region
If there is anyone that is interested in a
session, then please forward the
information and request to Leanne?
James asked on the dates – which will be
ongoing until December.
When are the next HIA committee
meetings?
Cheryl



Health planning take part in NL right now
Sandra is working on the nursing policies
guidelines
Two other communities would like to
work with the nursing policies as well
95
Actions
A5: Leanne to forward
the BC Schedule to
distribute to the
committee and also the
dates of the next
committee meetings.
A6: Barb/Tracey to
ask questions in
reference to
screening and other
related topics for
communities and
provide an update
later.
Agenda Items
Notes
 Planning committee with Atlantic First
Nations Health Nursing Conference on
Oct. 2-4
 CDC perspective – NB invited the
communities and Lynn was there
 Protesis was discussed and that NB is
promoting immunization
 FYI – immunization for FN children are
usually well immunized, however,
children between 0-4 years of age need
to be looked at
Clinical Nurse (Barb)






Actions
THIF projects and one with Miramachi
will be working together with Burnt
Church
Sept. 18 will be meeting in Eel Ground,
Tracy will be the contact for FASD
Building Brighter Kids
Co-Chair with Amanda P for a meeting
that was attended at the IWK for the
mental health and addictions committee
Cheryl: has there been outreach for the
alcohol strategy with FN communities?
Barb has only heard it at one place, but
clarified that university students are the
main target
The NASPS position has been posted
James:



Provided a report that could be referred
to.
What are conversational maps? They are
maps as visual tools to discuss with
diabetes patients about their diabetes
and medication.
They are tools that could be used for the
patients. There is a 30 min slot for the
nursing conference. Tammi mentioned
that Lennox have had a provincial person
that had trained someone in that
community.
Philippa:

From Gillian at CMM – the province has
offered training for screening for hearing
and speech
96
A7: John will touch
base with Marie to
discuss any potential
programs for AHHRI
and NBCC and
Miramachi
Agenda Items
Notes
 A proposal has been submitted to FNIHB
to cover the costs
 The Jordan’s Principal is awaiting the
final decision – seemed positive
 Adele has been hired to map out what
the services are available in communities
and the province
 Pictou folks were interviewed and the
interview will be aired on Sept. 7 on
APTN
 Gillian can address the questions that
Barb and other have stated
 Children are not getting screened at the
community level…
Aboriginal Head Start











10. Review of
Action Items
11. Closing Prayer
Literacy night in FF and Buctouche
Phonics in Elsipogtog and ?
NBCC in development of special projects
Active Kids on the provincial committee
and putting together a special kits training
Updates on the website
Train the Trainer in phonics
Training set for ECE at the Rodd
Miramachi for the NB headstarts
Building Blocks training…
Orientation for the ECE training – got 5
but need 3 more students
On line courses
Orientation manual for the EC program
that is being completed
Refer to Topic #2


Closing remarks….just wait and see what
will happen when the MMAHB moves
forward
Closing prayer
97
Actions
Meeting Information
COMMITTEE: Public Health and Primary Care Committee
DATE: December 11-12, 2012
LOCATION: Holiday Inn Harbourview, Dartmouth Nova Scotia
Time
10:0010:30
10:3011:00
11:0012:00
12:00-1:00
1:00-1:30
1:30-2:30
2:30-2:45
2:45-3:15
Agenda Items
Item
Opening Prayer, Introductions and Ice Breaker
Background on MMAHB/MMAHB Evaluation
Process
Review of FNIHB Programs and Resources
9:00-9:15
Lunch
MMAHB Cycle (Planning and Communications
Scope of Decision Making
Break
Committee Membership, Activities, and
Roles/Responsibilities
Meeting Processes and Administration
Preparing for First Nations Co-chair Selection
Preparation for Day 2 Activities
Final Thoughts and Closing
DAY 2
First Nations Co-Chair Selection
9:15-12:15
Brainstorming Activities for Workplanning
12:15-1:00
1:00-3:00
Lunch
Brainstorming Activities for Workplanning
3:15-3:45
3:45-3:50
3:50-4:15
4:15-4:30
Presenter
Robin Boychuk, FNIHB
Amanda Peters, APC
Wade Were, FNIHB
Amanda Peters, APC
Wade Were, FNIHB
Robin Boychuk, FNIHB
Amanda Peters, APC
Amanda Peters, APC
Robin Boychuk, FNIHB
First Nations Committee
Members
Committee. Facilitated by
Consultant
Committee. Facilitated by
Consultant
Notes on the Agenda
1. Documents that will be provided to you include:





Slide Show from Orientation Session
Terms of Reference for MMAHB Committees
MMAHB Evaluation Report
Contact Sheet for all members of the three (3) Committee and the MMAHB
Elder Care Strategic Plan, Mental Health and Addictions Strategic Plan, Child and Youth
Strategic Plan.
98
2. To prepare you may want to:




Review the Guiding Principles Document
(http://www.apcfnc.ca/en/health/resources/HealthPrioritiesGuidingPrinciplesFinalVersion
May2011.pdf)
Review the Terms of Reference (http://www.apcfnc.ca/en/health/mmahb.asp)
Think about items/issues that you want the committee to be working on
Note that lunch will be provided
99
Public Health & Primary Care Committee Meeting
Holiday Inn Harborview
December 11 and 12, 2012
Attendees:
Voting members:
Dan MacDonald
Leila Gillis
Roseanne Sark
Beverley Madill
Laurie Nicholas
Elaina Bigras
Janna MacKay
Non-voting/Observing members:
Amanda Peters
Chelsea Googoo
Linda McCallum
Wade Were
Len O’Neill
Brenda Roos
Agatha Hopkins
Robyn Boychuk
Representing:
Miawpukek
FNIHB
MCPEI
UNSI
MAWIW
UNBI
CMM
APC
APC
FNIHB
FNIHB
FNIHB
FNIHB
FNIHB
FNIHB
Regrets: Sandra Musgrave
Note: Before the meeting officially started FNIHB Regional Director Debra Keays-White
came in to announce the staffing changes occurring at the FNIHB office. Peter
MacGregor is now the acting manager of the mental wellness programs temporarily until
the manager position is filled. Charmane Kay will continue to be part of the IRS
program until the position is filled.
Agenda Items
Opening Prayer,
Introductions and Ice
Breaker
Background on
MMAHB and MMAHB



Notes
Opening Prayer: Roseanne Sark
Introduction & Ice Breaker:
Amanda Peters
Amanda Peters provided a
background on the MMAHB
100
Actions
Agenda Items
Evaluation Process
Review of FNIHB
Programs & Services

MMAHB Cycle

Scope of Decision
Making

Committee
Membership,
activities &
Roles/Responsibilities

Notes
evaluation process and the
contents of the MMAHB
Orientation Package.
Wade Were reviewed the FNIHB’s
programs and services outlined in
the attached MMAHB Committee
Orientation: FNIHB’s role,
responsibilities, portfolios and
goals.
Amanda presented a detailed
description on how the MMAHB
cycle works, when meetings take
place, and the MMAHB
communications.
Wade presented and explained a
detailed process on how decisions
are made between the FN parties
and FNIHB. There are 3 levels of
decision making: 1. Shared
Decision; 2. Funding Decision
(includes allocation); 3. Policy and
planning Decision. Both Elaina
and Roseanne would like First
Nations to be included in the
FNIHB work plans, Leila agreed
another lens would benefit. Most
FNIHB work plans are due in
February each year then rolled
out April1st.
Robyn explained the membership
of the voting members (includes a
representation from the 6 Atlantic
tribal organizations and 1 FNIHB
employee). The non-voting
members would be APC and
FNIHB staff. Robyn also
explained how the committee
activities in detail as well as the
101
Actions
#1: Chelsea will
send the calendar
invite to every
MMAHB and
committee meeting
for 2013.
#2: Chelsea will add
the MMAHB Chief
co-chairs to the
MMAHB non-voting
section of the
membership list.
Agenda Items
Meeting Process and
Administration


Preparing for First
Nations and Co-Chair
selection

Preparation for Day 2
Activities

Final Thoughts and
Closing

Notes
roles and responsibilities, the
attendance of the voting members
and the appointments of the cochairs.
Amanda explained the meeting
process and administration part
behind APC (the work of the
health policy analyst & the
MMAHB Coordinator). The
process includes: deadlines of
paperwork, the logistics and the
planning of meeting dates,
locations, templates and any other
additional work provided by APC.
Note: during discussion, a gap
was identified: how will the AFN
information come to the
committee table, since the
National Health Techs Sally &
Peter do not sit on all 3 of the
committees.
Amanda explained the process of
the voting of the FN co-chair. The
selected co-chair will be chosen
for the duration of 2 years.
Both Robyn and Amanda
explained that a facilitator will
attend day 2 of the meeting for
brainstorming for the PHPC work
plan.
Amanda provided a recap of the
days’ activities and what is
expected out of day 2.
The day 2 report to be provided by facilitator at a later date.
102
Actions
Wellness Committee Meeting
May 23, 2012
The CMM Board Room, Millbrook First Nation
9:00 a.m.
Opening Prayer
Welcome and Opening Remarks
Review and Approval Agenda and minutes
Follow up actions, Updates (all)
1030 am
Break
10:45
Wellness Workplan
11:30
FNIHB Co-Chair nomination and appointment
1:00 pm
Updates - all
2:00 pm
HAC evaluation update- Amanda Peters
2:45 pm
19/12
Input for Wellness Subcommittee Report for next MMAHB meeting (June
3:15 pm
Closing Prayer
103
Wellness Meeting
CMM Office, Millbrook, N.S
May 23, 2012
Attendees:
Loraine Etter, APC
Josephine Muxlow, FNIHB
Amanda Peters, APC
Barbara Broom, FNIHB
Sally Johnson, UNSI
Lita Richardson, MAWIW
Gerard Gould, MCPEI
Janet Pothier, CMM, Wellness Co-Chair
Jennifer Gagnon, Observer
Peter Birney, UNBI
Chelsea Googoo, APC
Regrets:
Laurie Nicholas, Val Polchies, Gena Gallant
1.) Opening Prayer: Sally Johnson
2.) Welcome and Opening Remarks: Co-Chair Janet Pothier
3.) Review and approval of agenda and minutes:
-
Added to the agenda: bath salts issue.
FNIHB Co-chair nomination will be deferred until the next meeting.
Wellness Work plan: deferred to the next meeting, including the membership of
the committee list; instead a discussion on info about national updates.
REES: Sally wants to add to the agenda (after lunch).
Amanda: wants the child & youth strategic directions added.
Note: No changes to the minutes to the September 7&8th meeting. Minutes are
approved.
Review of September, 2011 Action Items:
104
#1: completed.
#2: completed.
#3: completed.
#4: not completed.
#5: completed.
#6: Loraine will send out instead.
#7: no updates have been sent.
#8: it was taken to the MMAHB; no decision has been made.
#9: feedback given; completed.
#10: not completed; not done; however they will start.
#11: completed; Janet will follow up.
#12: completed; Janet will photocopy to pass out to the committee members; Sally will
forward the document to the wellness committee members.
#13: completed.
#14: not completed; follow up with Laurie.
#15: completed.
#16: completed.
#17: not completed.
Review of November 30 TRI-HAC action items:
#1: no changes; overturned.
#2: Amanda will send; Chelsea did not.
Note: Minutes have been approved by the committee with the changes completed
electronically and immediately by Chelsea Googoo.
4.) HAC Evaluation Update: Amanda Peter:
Amanda provided Lita Richardson a brief history on the MMAHB and its’
subcommittees. Valerie Gideon will speak about the MMAHB evaluation at the All
Chiefs and give an update/status. It has been put on hold since the fall of 2011.
Many people at the table are very discouraged about the federal cutbacks on the First
Nations Tribal organizations, especially in the health departments.
Janet: FN people are heavily being impacted on the federal cutbacks. It seems like the
only way to resolve many issues is through legal means and we need collective action
from the Chiefs in an attempt to halt further cuts since it seems the federal government
doesn’t consider FN health a priority.
Peter added that as we, the FN, have been cut dramatically and been trumped by
bilingualism from the government and it is viewed as a higher priority rather than First
Nations’ Aboriginal and Treaty Rights. There was no consultation from the federal level
to the Tribal organization level about the cutbacks.
105
AFN Health technicians meeting in June will be held for 3 days in Ottawa. The AFN
AGA takes place in July, 2012 and the federal cutbacks will be the dominant theme
especially in health.
Action Item #1: Sally will send the committee the agenda and is asking for
recommendations to be added to the AFN Health Technicians agenda for the
June meeting.
5.) Wellness Work Plan:
Peter: to be added:
- NIHB Resolutions/Key activities section: Opioid Addiction/methadone clinics.
- Medical transportation.
Josephine: the brighter futures and building healthy communities section; should be
added to this years’ work plan.
Action Item #2: Janet wants to have a strategically written work plan in order to
share with our communities.
Gerard: communication is still not going through from the feds to the grassroots. Is
there anything being done to have better communication to the communities?
6.) FNIHB Co-Chair nomination and appointment:
This item has been deferred until the next wellness committee meeting.
7.) Updates – All:
Loraine Etter, APC:
Loraine’s update is provided on hard copy.
Peter Birney, UNBI:
Peter’s update is provided on hard copy.
Janet Pothier, CMM:
Janet’s update is provided on hard copy.
Action Item #3: Janet will send Chelsea the Summit on Mental Health document to
email the committee members.
Lita Richardson, MAWIW rep; Burnt Church Health Director:
Medical transportation received cutbacks for the methadone patients; however 2 nurses
and a pharmacist will now be in Burnt Church; Loraine said a van may be available from
FNIHB to the methadone clients during the work week.
106
Sally Johnson, UNSI:
Sally’s update is provided on hard copy. AFN’s committees will be restructured due to
the loss of AFN staff because of the federal cutbacks. RHS Survey will include: NS, PEI
and NFLD. Deadline is May 30 for the complete survey report, both Fred Wien and
Mindy Denny will report. UNSI have not received federal health cutbacks to date.
Barbara Broom, FNIHB:
Barbara’s update is provided on hard copy.
Action Item #4: Chelsea will send FNIHB’s Video Conferencing education
sessions spring session for 2012.
Josephine Muxlow, FNIHB:
Josephine’s update is provided on hard copy.
There was some discussion around the Bath Salts issue at the table, many technicians
are very worried about this new drug and the impacts of Bath Salts will have in the
communities.
Amanda Peters, Report and Recommendations of the Mental Health and Addictions
Strategy Advisory Committee Addressing First Nations Concerns in N.S.: Amanda
provided a hard copy.
Action Item #5: Amanda will send/email Peter Birney a copy of the above
mentioned report.
8.) Input for Wellness subcommittee report for the MMAHB:
-
Update on the bath salts, it needs to be discussed as an emerging issue.
Possibility: invite someone from Pictou Landing to update the committee on the
collaborative work done to address the issues of Bath Salts in Pictou County.
Recommend: action/address the federal cutbacks.
IRS funding.
Follow up meeting with a teleconference meeting date: Tuesday, June 26, 2012 at
10:00 am to 11:30 am for reviewing the action items, the minutes, the new agenda and
new meeting date.
Action Item #6: Chelsea will send a calendar invite for the wellness
teleconference meeting. (completed May 24).
107
Wellness Committee Meeting
September 6, 2012
The APC Board Room, Cole Harbour NS
9:00 a.m.
Opening Prayer
Welcome and Opening Remarks
Review and Approval Agenda and minutes
9:30-10:30
Committee member Updates (highlights)
1030 am
Break
10:45
MMAHB Evaluation
11:00
Federal First Nations Tobacco Strategy
11:30
Addictions meeting MMAHB September 20
12:00 pm
Lunch
1:00 pm
DUPP Funding/Presentation
2:00 pm
NAYSPS Coordinator Networking Session - Eval
2:30 pm
Break
2:45 pm
Federal Co-chair nominations and replacement
(discussion)
3:00 pm
Input for Wellness Subcommittee Report for next
MMAHB meeting (September 19 & 20, 20102)
3:15 pm
Closing Prayer
108
Wellness Committee
September 6, 2012
APC Head Office, Dartmouth, Nova Scotia
Attendees: Sally Johnson, Barbara Broom, Janet Pothier, Gena Gallant, Peter Birney, Joseph
Denny, Cindy Ginnish, Tracy Lovett, Laurie Nicholas, Christiane Poulin, Josephine Muxlow,
Amanda Peters
Agenda Items
1. Opening Prayer /
Welcome and
Introductions
2. Review and
Approval of the
Agenda and Minutes
Notes
Opening Prayer – Sally Johnson
Co-Chair: Janet Pothier Welcome and
Introductions
There is a DUPP Evaluation available online.
Maybe we should look at it. Will look for the
Evaluation for lunch. Agenda Accepted by
consensus
Minutes: Pasted with the following changes.
 Cindy Ginnish sent her regrets for the
May 23 meeting.
 Page 3 change the language to
Language Rights from Aboriginal Treaty
Rights.
Action Items:
 A1: Completed.
 A2: Will be worked on the autumn.
 A3: Completed
 A4: Completed
 A5: Completed
 A6: Completed
3. Committee Member
Updates
Cindy Ginnish:
 Reviewing the presentation provided in
109
Actions
A1: Sally will send
the National health
Techs agenda to the
group for comments
and
recommendations for
the September 2012
meeting
A2: June 26, 2012
Wellness
teleconference
Notes: Chelsea to
send out to the
Committee.
A3: Chelsea to
ensure that email list
for the Wellness
Committee is
updated.
A4: Cindy to forward
the FN Mental
Agenda Items
Notes
the package re: Regional Presentation
on Key Renewal Achievement and
Plans to Date.
 Cindy will be leaving Native National
Addictions Partnership Foundation
(NNAPF), will no longer national
representative
 Wellness Committee could work to
move renewal activities forward in the
work plan.
 Maliseet Mental Wellness Team did not
understand how to connect to the
NNADAP workers and treatment
centres at a meeting in July. Discussion
on how to make those connections and
helping people to understand the
processes for treatment centres and
how to access them.
Joe Denny:
 Reviewed the programs under
NADACA in Nova Scotia i.e.
Prescription Drug and Opioid
Programs, Relapse Program etc.
Christiane Poulin:
 Staffing issues at FNIHB reviewed.
Valentino Polches and Patrick Small
Legs-Nagge are both gone. Those
positions are open but subject to Work
Force Adjustment within the federal
government. IRS position is currently
open as well.
Laurie Nicholas:
 Reviewing her experience with and
invited Elder to some NB communities
to talk about wellness. For more
information: www.turtlelodge.org
 Mi’kmaq Maliseet Healing Network:
funding ending soon, June 2012. Need
to find a way to sustain it.
 Reclaiming Our Ancestral Footsteps
pilot project has ended. Reviewing
evaluation at present. Will be
presenting at the Health conference in
November. Thinking about next steps.
Janet Pothier:
 The HSIF Provincial Project on MHA
has been funded, Focus of the project
to develop relationships to have
services offered at the community level.
110
Actions
Wellness Continuum
Framework to the
Wellness Committee
– Completed at the
meeting
A5: Joe and Janet to
speak about the Give
Us Wings Project
and NADACA having
a position on the
Steering Committee
A6: Discussion on
having Barb Martin
come present to the
Wellness Committee
Agenda Items
Notes
All NS communities are involved.
Steering Committee will be meeting and
Coordinator to be hired
 NNAYPS Networking Session,
November 13-14 for the 11 projects.
 Provincial Tripartite Disabilities Project
working with provincial groups and
communities looking at services
available or not available in FN
communities. (both provincial and
federal services) Will be working on an
Action Plan to address identified gaps.
 Cultural Safety Modules for training
health staff at the province continues
through the Give US Wings Project.
Barbara Broom:
 Working with NB Mental Health Project
in Miramichi with the 3 communities.
 Working with the 3 Mental Wellness
Teams. Maliseet Team very busy
 Work with Family Health Programs as
well.
 Sits on National NNAYPS, BHC/BF
Committees and would like to attend
NNAYPS Networking Session
Peter Birney:
 No update per se: Dealing with Budget
cuts at UNBI
 UNBI continuing the NNAYPS
program. Currently collecting
community work plans
 HSIF meeting Monday, two new
projects for consideration from the
RHAs about cultural education. They
look promising.
Sally Johnson:
 Meeting with FNGC in Yellowknife this
month. Has concerns and questions
regarding the REES for discussion.
REES Coordinator is Mindy Denny and
Statistical Analyst Gerald Gloud. REES
will not cover all communities. Survey
should be out in the new fiscal year at
latest.
 RHS Report is due this month. The
Advisory Group and MHRG will be
meeting September 28, 2012 to review
report.
 National Health Technicians Meeting at
111
Actions
Agenda Items
4. MMAHB Evaluation
Update – Amanda
Peters
Notes
AFN is this month.
 Concerns over potential cuts to NIHB
benefits due to increased numbers from
McIvor and Qalipu. Will keep everyone
updated on NIHB issues that are
coming forward
Josephine Muxlow:
 Working with the Mental Health Nurse
at the Healing Lodge at Tobique.
 Involved in Wampum training on
addictions and trauma. Good to build
capacity in the communities
 Involved in working with Susan Bear at
St. Mary’s on Wellness and Addictions
 Steering Committee on Mental
Wellness teams, mostly Tui’kn.
Currently discussion the evaluation
Tracy Lovett:
 Introducing herself to the Wellness
Committee as the new FASD/IP Nurse
at FNIHB and the current projects she is
working on.
Gena Gallant:
 Currently working on 4 new tele-health
projects with Bear River, Glooscap will
be next in October, Indian Island and
Abegweit.
 Fall Schedule for the fall
Videoconferencing training Sessions
has just gone out. Currently recruiting
presenters.
 Training and Capacity Building: CBRT
Training Completed. Privacy training
workshops available.
Review of the proposed Terms of Reference for
the MMAHB and the Committees. Information
purposes only. Review of the next steps
assuming approval of the ToRs by the
MMAHB.
 Conversation around inclusion of RAPC
at the Wellness Committee and
reporting to MMAHB. Christiane Poulin
will report from RAPC to the Wellness
as she will be the co-chair of both
committees.
 Roles and responsibilities: where did
the clause go about committee
members staying for the entire meeting
or not receiving their travel. This was
112
Actions
Agenda Items
5. Federal First
Nations Tobacco
Strategy – Heather
MacDonald
6. Addictions Meeting
at the MMAHB Sept.
20
Notes
not approved.
 Discussion over the $50,000.00 funding
limit. Will it be too many issues going to
MMAHB?
 Need work on communications.
Amanda Peters presented on the Tobacco
Strategy. Some discussion around criteria etc.







Review of the MMAHB discussion on
how the Addictions and Treatment
Centres issue came up at the MMAHB.
Cindy Ginnish reviewed the activities of
Rising Sun in terms of renewal i.e.
Prescription Drug Misuse Day Program
at Rising Sun. Staff at the Rising Sun
had to overcome some of the ideas that
they maintained that are considered out
of date. Have an LPN on staff at the
Rising Sun.
It would be good to address the issue of
methadone use in the Treatment
Centres, how do we get people into
treatment? Methadone is bigger than
Treatment Centres, it includes
legislation, role of physicians.
We have to look at the root of the
addictions. Addictions is a symptom of
something else and we need to address
this. It is not a quick fix. Leadership
needs to recognize this. More
addictions counselors, more RCMP etc.
are not going to resolve this. Have to
address root causes of housing,
poverty, unemployment, Residential
schools, and historical trauma. This
message needs to be understood.
Need to understand the importance of
support systems. People will not
succeed in treatment if their
circumstances do not change.
Need to also address the issue that
prescription drugs are abused because
they are prescribed by physicians and
paid for by NIHB or other health
insurance programs. Not always illicit
drug use. There are two sides to this
issue.
Question brought up at MMAHB
113
Actions
A7: Amanda to
request to the preMMAHB that the
Treatment Centre
presentations on the
first day, September
19, 2012.
Agenda Items











Notes
included: Which treatment centres
accept methadone clients in residential
programs? Rising Sun is not there yet.
Cannot accommodate
Clients on methadone need to be
counseling to address some of the
issues that cause them to be addicts.
Linkages between issues of addiction
and FASD. This is an example of unmet
needs that needs to be addressed.
Programs need to build capacity.
Counselors are getting burnt out, this is
difficult work. Address this issue as well.
Need resources for the counselors to
have their needs met. They are
essentially on call 24 hours a day.
Need to use the NIHB statistics on
addictions to get the supports to be able
to run these programs. It should be
‘needs based.’ Chiefs need to see the
numbers associated with methadone
and how the treatment centres deal with
this.
We need long term mental health
counseling in our FN communities.
The RDG of AANDC needs to attend
and understand their role in these
issues.
Need to have input into the discussions
from the youth.
We have come a long way. We have
developed our own paradigm for First
Nations for treatment etc. Need to
recognize this. What works in
mainstream does not work but it is
moving in a way to allow for more
indigenization.
What might be a good exercise is to
look at the 17 centres in Canada that
currently service methadone clients and
understand how they came to this.
Many players in these issues:
NNADAP, NNAPF, Tri-partite Forum,
Board of Directors consisting of
leadership, Atlantic Regional
Partnership Committee. Obvious that
more communications are needed.
Need to hear success stories and learn
from these.
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Actions
Agenda Items
7. DUPP
Funding/Presentation









Notes
Bev Smith presentation on Prescription
Drug Abuse Prevention and Promotion
at Elsipogtog. Based on youth and
culture as a protective factor and
educational tool to spread the message
of the dangers of Prescription Drug
Abuse etc.
Need to also think about energy drinks
as an addiction
The three options presented have been
sent out to the Health Directors.
If Wellness opts for another option, it
would have to be sent out again for
Health Director input
Only 4 Health Directors responded to
the request for input identifying Option 1
(3 votes) or 2 (1 Vote) as preferable.
Discussion around capacity of small
verses large communities as well as
clustering. Sometimes it is effective
sometimes it is not.
Communication needs to include the
following ;
- funding commitments
- budget breakdowns and
possibilities
- clearer options
- flexibility
- time frames
- turn-around time
- clearer communication on
criteria
There is a recommendation to get the
health techs to go back to the HDs to
touch base again with the HDs, in
addition is to send it out again in mass
email, as well as health tech follow up
Decision: all the options will be left as
is, as a RFP, with clarification in some
areas: flexibility, amounts, timeframes,
criteria, no carry over, etc.
-
8. NAYSPS
Coordinator
Networking Session Evaluation
Teleconference will be for next
Friday for 9:30 am next Friday,
Sept. 14.
Will be completed via email.
Actions
A8: Janet Pothier to
reword and send out
DUPP options to the
Health Directors
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A9: Janet to follow
up on this
Agenda Items
9 Input for Wellness
Subcommittee Report
for next MMAHB
meeting (September
19 & 20, 2012)
10. Closing Prayer
Notes
Completed
Sally Johnson
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Actions
Meeting Information
COMMITTEE: Mental Wellness Committee
DATE: January 8-9, 2013
LOCATION: APC Offices, 153 Willowdale Drive, Dartmouth Nova Scotia
Time
10:0010:30
10:3011:00
11:0012:00
12:00-1:00
1:00-1:30
1:30-2:30
2:30-2:45
2:45-3:15
Agenda Items
Item
Opening Prayer, Introductions and Ice Breaker
Background on MMAHB/MMAHB Evaluation
Process
Review of FNIHB Programs and Resources
9:00-9:15
Lunch
MMAHB Cycle (Planning and Communications
Scope of Decision Making
Break
Committee Membership, Activities, and
Roles/Responsibilities
Meeting Processes and Administration
Preparing for First Nations Co-chair Selection
Preparation for Day 2 Activities
Final Thoughts and Closing
DAY 2
First Nations Co-Chair Selection
9:15-12:15
Brainstorming Activities for Workplanning
12:15-1:00
1:00-3:00
Lunch
Brainstorming Activities for Workplanning
3:15-3:45
3:45-3:50
3:50-4:15
4:15-4:30
Presenter
Robin Boychuk, FNIHB
Amanda Peters, APC
Wade Were, FNIHB
Amanda Peters, APC
Wade Were, FNIHB
Robin Boychuk, FNIHB
Amanda Peters, APC
Amanda Peters, APC
Robin Boychuk, FNIHB
First Nations Committee
Members
Committee. Facilitated
Consultant
Committee. Facilitated by
Consultant
Notes on the Agenda
1. Documents that will be provided to you include:





Slide Show from Orientation Session
Terms of Reference for MMAHB Committees
MMAHB Evaluation Report
Contact Sheet for all members of the three (3) Committee and the MMAHB
Elder Care Strategic Plan, Mental Health and Addictions Strategic Plan, Child and Youth
Strategic Plan.
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2. To prepare you may want to:




Review the Guiding Principles Document
(http://www.apcfnc.ca/en/health/resources/HealthPrioritiesGuidingPrinciplesFinalVersion
May2011.pdf)
Review the Terms of Reference (http://www.apcfnc.ca/en/health/mmahb.asp)
Think about items/issues that you want the committee to be working on
Note that lunch will be provided.
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Mental Wellness Minutes
January 8, 2013
APC Office
Attendees:
Voting members:
Janet Pothier
Gillian Bailey
Peter Birney
Tammy Arsenault
Notoria Hinks
Non-Voting/Observing members:
Chelsea Googoo
Annette Waterman
Amanda Peters
Robin Boychuck
Peter McGregor
Charmane Kay
Josephine Muxlow
Wade Were
Representing:
CMM; Co-Chair
FNIHB; Co-Chair
UNBI
MCPEI
NFLD
APC
APC
APC
FNIHB
FNIHB
FNIHB
FNIHB
FNIHB
Regrets: Laurie Nicholas
Agenda Items
Opening Prayer
Welcome &
Introductions:
Background on
MMAHB/MMAHB
Evaluation Process



Notes
Josephine Muxlow
Amanda Peters and Robin
Boychuck made introductions
around the table and did an
icebreaker activity.
Amanda Peters and Robin
Boychuck provided a background
on the MMAHB evaluation
process and the contents of the
MMAHB orientation package.
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Actions
#1: Chelsea will add
the committee TOR
into the packages on
day 2.
#2: Chelsea will add
the following names
to the MMAHB
master contact list:
FN co-chair, Peter
MacGregor &
Charmane Kay.
Agenda Items
Review of FNIHB
Programs and
Resources

MMAHB Cycle

Scope of Decision
Making


Committee
Membership,
Activities, and
Roles/Responsibilities


Meeting Processes
and Administration

Notes
Wade Were reviewed the
FNIHB’s programs and services
outlined in the attached MMAHB
committee orientation: FNIHB’s
role, responsibilities, portfolios
and goals.
Amanda Peters presented a
detailed description on how the
MMAHB cycle works, when
meetings take place, and the
MMAHB communications.
Wade Were presented and
explained a detailed process on
how decisions are made between
the FN parties and FNIHB. There
are 3 levels of decision making: 1.
Shared Decision; 2. Funding
Decision (includes allocation); 3.
Policy and Planning Decision.
Explanation and discussion on
the term co-management as
different from the financial
intervention definition commonly
used in First Nations
communities.
Robin Boychuck explained the
membership between the voting
members and the non-voting
members (includes a
representation from the Atlantic
tribal organizations and the
FNIHB employees). Robin also
explained how the committee
activities in detail as well as the
roles and responsibilities, the
attendance of the voting
members and the appointments
of the co-chairs.
Discussion about RAPC (see
action item #3).
Amanda Peters explained the
meeting process and
administration behind APC (the
work of the health policy analyst
and the MMAHB coordinator).
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Actions
#3: the co-chairs will
present at the RAPC
meeting on January
17 and request to
have someone from
RAPC to sit on the
mental wellness
committee as a
permanent observer.
Agenda Items
Preparing for First
Nations Co-chair
Selection

Preparing for Day 2
Activities

Final Thoughts and
Closing

Notes
The process includes: deadlines
of paperwork, the logistics of the
planning of meeting dates,
locations, templates and any
other additional work provided by
APC.
Amanda Peters explained the
process of the voting of the FN
co-chair. The selected co-chair
will be chosen for the duration of
2 years.
Robin Boychuck and Amanda
explained that a facilitator will
attend day 2 of the meeting for
brainstorming for the NIHB work
plan.
Amanda provided a recap on the
day’s events.
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Actions
POSITION DESCRIPTION
Position Title:
MMHAB Coordinator – Chelsea Googoo
Department:
Health
Salary:
Term:
April 1st, 2013 to March 31st, 2014
Location:
APC Head Office, Cole Harbour Reserve, Dartmouth, NS
Position Reports to:
Amanda Peters, Senior Health Policy Analyst
Positions Supervised:
N/A
Objective
To provide required administrative, logistical, analytical and other support for the Mi’kmaq
Maliseet Atlantic Health Board (MMAHB) and related committees.
Position Overview
This position will coordinate all the work related to the MMAHB by providing administrative and
logical support with and participate in committees and sub committees meetings.
Essential Functions and Duties
1. Scheduling MMAHB/Subcommittee Meeting Dates, Meeting Notices, booking meeting
location, set up catering, preparing meeting packages, agendas, drafting minutes and
onsite meeting management;
2. Draft MMAHB Meeting Minutes and emailed to committee members within two weeks
after the meeting for review;
3. Revision of minutes and recirculation of approved minutes to committees and
communities;
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4. Dissemination of health material to communities, health directors, health technicians and
Chiefs;
5. Preparation of Annual MMAHB/committee report;
6. Coordination of the MMAHB committees: MMAHB, Child & Youth, Wellness, Primary
Public Health, Co-Chairs, Mental Health and Addictions Networking group and any
related additional meetings as needed;
7. Administrative Duties for MMAHB. Report gathering and formatting, preparation of
Correspondence, faxing, mailing/emailing, create and maintain a MMAHB filing system,
photocopying, maintaining office equipment, ordering office supplies;
8. Ensure that Sharepoint and webpage are up to date as requested by supervisor;
9. Other duties requested by supervisor
Performance Measurements
1.
2.
3.
4.
5.
6.
7.
Quality minute generation & consistent standards for meeting coordination;
Completion of tasks in timely and professional manner;
Qualities of all work as per grammar, spelling, completeness and are timely;
Health materials are out to the communities in a timely manner and are accurate;
Report submitted to FNIHB is complete and accurate
Facilitate teamwork with FNIHB and APC Staff;
MMAHB materials are organized and materials are sent out to the communities is
accurate and timely;
8. Ability and willingness in assisting when requested.
9. Sharepoint and website are up to date.
Qualifications
Education/Certification:

Possess a recognized diploma or certificate in office/administrative
management/assistance and 1-3 years recent experience working as an Administrative
or Office Assistant (a combination of relevant education and experience will also be
considered);
Required Knowledge:





Proficient knowledge of computer programs: Word, Excel, Power Point
Extensive knowledge in communications and minute generation
Some knowledge of the health care systems in Atlantic Canada
1-3 years work experience working with First Nations/organizations, preferably in the
area of health
Knowledge of First Nation communities and organizations in the region
Experience Required:


Demonstrated excellent administrative and organizational skills
Excellent minute taking ability (min. 40 WPM)
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Skills/Abilities


Excellent computer, oral, organizational and written communications skills
Ability to speak Mi’kmaq, Maliseet or Innu language would be an asset.
Position Requirements
Must possess a valid driver’s permit, have a vehicle, and be willing to travel as required
If all qualifications are equal, preference will be given to persons of Aboriginal ancestry.
Annual Performance Review
Continued employment is also contingent upon your satisfactory performance. To assess your
performance, you will be subject to a review in accordance with the APC Human Resources
Policy.
ACKNOWLEDGEMENT
I have read the terms and conditions of employment as outlined in this agreement and attached
hereto and I accept and agree to such terms and conditions.
__________________________________ Date: ________________________
Chelsea Googoo, MMHAB Coordinator
____________________________________
Date: _________________________
Amanda Peters, Senior Policy Analyst
____________________________________
Date: _________________________
Shawn Holte, Director of Operations
____________________________________
Date: _________________________
John G. Paul, Executive Director
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APC Health
Individual Work Plan 2010-2015
Chelsea Googoo, MMAHB Coordinator
GOAL
1.0 Organize MMAHB and related
Committee meetings (Child and
Youth, Wellness, PHC, CYMHA,
Health Technicians and Co-chairs)
2.0 Follow up to MMAHB and
related Committee meetings
ACTIVITIES
TIME FRAME
ANTICIPATED RESULTS
1.1 Find location for
meeting, prepare proper
contracts for location,
logistics and catering.
Collaborate with SHPA and
Legal at APC.
1.2 Send out invitations to
committee members.
1.3 Prepare travel claims
for Chiefs committee
members
1.4 Assist co-chairs / APC
staff in preparing agenda
1.5 Collect agenda
presentations
1.6 Send out reminders to
Chiefs and committee
member
1.7 Ensure agenda is
completed and sent to
committee participants
2.1 Begin preparation for
next meeting (locations,
logistics etc.)
Immediately following the
previous meeting when date
and location have been stated
Ensure location and food for meeting
At least one month prior to
meeting
Two weeks prior to meeting
Ensure all members are informed of
date, location of next meeting
To ensure all committee members
are properly reimbursed for their
expenses
Completed agenda
2.2 Type minutes from
meeting and summary of
Action Items
One – two weeks prior to
meetings
One week prior to meetings
Have the agenda ready ahead of time
One week prior to meeting
Ensure all members are informed of
date, location of next meeting
Two days prior to the meeting
Have the agenda to the committee
members to review before meeting
The week following the
previous meeting when
location and date have been
stated.
One week following the
meeting
To ensure location and food for
meeting
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Type minutes while still fresh in
memory
GOAL
3.0 Organize Health Directors
Meetings, three times per year
4.0 General maintenance of
health filing system
ACTIVITIES
TIME FRAME
ANTICIPATED RESULTS
2.3 Distribute draft
minutes to co-chairs for
approvals
2.4 Ensure travel claims
submitted to finance
2.5 Send out reminder to
committee members to
submit their travel forms
within the 30 day time
window
2.6 Distribute finalized
minutes to committee
members
2.7 Ensure that location
invoices etc are submitted
to finance
See 1.0 and 2.0
One week following meeting
Approval of minutes by co-chairs to
ensure clarity
Within one week of the
meeting
Within 15 days of meeting
Ensure committee members are
reimbursed.
Ensure committee members have
their forms/invoices/receipts in for
reimbursements.
Three weeks following the
meeting
One week following the
meeting
Committee members will be able to
review minutes and proceed with
action items
To ensure that invoices are properly
submitted to finance
See 1.0 and 2.0
See 1.0 and 2.0
4.1 Organizing health files
that pertain to MMAHB
coordinators role
Twice a year
Organized filing system for easier
access.
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