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Made as of the 13th day of October, 2011
Her Majesty The Queen In Right Of Canada
as represented by the Minister of Health
Her Majesty The Queen In Right Of The Province Of British Columbia
as represented by the Minister of Health
First Nations Health Society
First Nations Health Council
NOW THEREFORE in consideration of the mutual covenants and agreements herein contained and other good and valuable consideration, the receipt and sufficiency of which the Parties hereby acknowledge, the Parties agree as follows:
(1) Agreement means this agreement including any schedules to this agreement, as amended from time to time.
(2) Annual Federal Amount has the meaning given in section CF 3 of Schedule 1.
(3) Annual Report means a document to be prepared by the FNHA as set out in section 5.4.
(4) BC First Nation means: (i) a "band" within the meaning of the Indian Act (Canada) in British Columbia and (ii) any Self-Governing First Nation, and the plural term BC First Nations refers to all or a number of such bands or Self-Governing First Nations as the context requires.
(5) BC Health Authority means a board established under the BC Health Authorities Act or the regulations thereto, as amended, and the Provincial Health Services Authority established under the BC Society Act.
(6) British Columbia means Her Majesty the Queen in right of the Province of British Columbia, as represented by the Minister of Health.
(7) Canada means Her Majesty the Queen in Right of Canada, as represented by the Minister of Health.
(8) Canada CA means a contribution agreement between Canada and a First Nation Health Provider in British Columbia.
(9) Canada Funding Agreement means the ten (10) year funding agreement as more particularly described in Part 1 of Schedule 1 (Canada Funding Schedule) which may be entered into at once or in stages for all or part of the Annual Federal Amount.
(10) FNHA means the First Nations Health Authority, a non-profit legal entity to be established with the process, powers and mandate set out in s. 4.2.
(11) FNHC means the First Nations Health Council, an unincorporated association described in section 4.4.
(12) FNHDA means the First Nations Health Directors Association, a society under the BC Society Act, described in section 4.5.
(13) FNHS means the First Nations Health Society, a society under the BC Society Act described in recital G.
(14) FN Health Programs means the health programs and services or benefits and related activities that the FNHA plans, designs, manages and delivers or funds the delivery of pursuant to this Agreement.
(15) Federal Health Programs means the health programs, services or benefits and related activities that are currently funded or delivered by Health Canada in British Columbia through the HC/FNIH Regional Office and set out in Schedule 3.
(16) First Nations Community Health and Wellness Plan means a plan developed by First Nation Health Providers pursuant to funding arrangements with the FNHA.
(17) First Nation Health Provider means any Indian band, Self-Governing First Nation, tribal council, First Nation organization or other person that is funded by the FNHA to provide FN Health Programs.
(18) HC/FNIH Regional Office means those parts of the Regions and Programs Branch of Health Canada (BC Region) which undertake the planning, design, management and delivery of certain Federal Health Programs.
(19) HC/FNIHB means the First Nations and Inuit Health Branch of Health Canada.
(20) Health Canada or HC means the federal Department of Health.
(21) Health Governance Structure means the structure described in section 4.
(22) Health Partnership Accord means the accord referenced in recital "C".
(23) Implementation Committee means the interim body referred to in section 7.1(1).
(24) Interim Health Plan means the plan or plans to be developed by the FNHA in accordance with the process set out in section 5.2.
(25) Interim Management Committee means the committee set out in section 7.3(1).
(26) Multi-Year Health Plan or MYHP means the plan to be developed by the FNHA in accordance with the process set out in section 5.3.
(27) NIHB Program means Canada's Non-Insured Health Benefits Program that funds a limited range of medically necessary health-related goods and services for eligible First Nations and Inuit persons which are not provided or insured through provincial or private health insurance programs.
(28) Parties mean Canada, British Columbia and the FNHS.
(29) Reciprocal Accountability has the meaning set out in section 2.2.
(30) Self-Governing First Nation means a First Nation in British Columbia that is recognized as self-governing by Canada as a result of a final self-government, treaty or land claims agreement.
(31) Sub-Agreements means the sub-agreements listed in Schedule 5.
(32) TCA:FNHP means the Transformative Change Accord: First Nations Health Plan (2006).
(33) TFNHP means the Tripartite First Nations Health Plan (2007).
(34) Transfer of Federal Health Programs has the meaning set out in section 6.3(1).
(35) Transition Team has the meaning set out in section 7.2(1).
(36) Tripartite Committee means the committee described in section 4.3.
(1) The purpose of this Agreement is to give legal expression to the Parties' commitment, under the British Columbia Tripartite First Nations Health - Basis for a Framework Agreement on Health Governance (2010) to conclude a Framework Agreement, and to their shared goal of improving the health and well-being of First Nations individuals and communities in British Columbia as envisioned in the Tripartite First Nations Health Plan (2007)by ensuring that BC First Nations are fully involved in health program and service delivery and decision-making regarding the health of their people in British Columbia. This Agreement sets out the Parties' specific commitments relating to the implementation of that vision, including:
(2) The Parties acknowledge that Federal Health Programs, other than the NIHB Program, are aimed primarily at Status Indians resident on reserve in BC, with the NIHB Program being aimed at all Status Indians resident in BC. The Parties anticipate that as the FNHA enters into relationships with the BC Ministry of Health and BC Health Authorities, including the provision of funding, such relationships may also benefit other First Nations persons in BC, the wider aboriginal population in BC and potentially the non-aboriginal population.
(1) The actions of the Parties under this Agreement will be based on reciprocal accountability, which means that the Parties will work together in a collaborative manner to achieve the objectives set out in Recital I and section 2.1, respecting both the letter and spirit of the Agreement, and in accordance with their respective obligations hereunder. In the event that implementation challenges are identified which do not constitute default under the terms of the Agreement but which nevertheless compromise its effectiveness or sustainability, the Parties will meet in accordance with processes established hereunder and with appropriate officials, or otherwise as agreed, and strive to develop responses, measures or strategies to meet the challenges identified, where possible. The Parties will also seek to apply the concept of reciprocal accountability at the regional and local level.
(1) The Parties recognize and agree that this Agreement reflects the state of their knowledge and understandings at the time of its drafting. With this Agreement, the Parties intend to enter into a long-term arrangement that will evolve over time. The Parties therefore agree to work together cooperatively in order to address the need, should it arise, for variations or additions to the terms of this Agreement.
(1) The FNHC is an unincorporated political organization, certain of whose members are signing this Agreement to express their support and endorsement of its contents in view of the FNHC mandate to oversee negotiations for this Agreement on behalf of BC First Nations. For greater certainty, the FNHC members shall not, by reason of any of them signing this Agreement:
(2) This provision shall not modify or limit any rights, obligations, responsibilities or liabilities of the FNHC members which may exist or arise at law independent of their signing this Agreement.
(1) This Agreement shall not have the effect of, or be interpreted as:
(2) The Parties acknowledge that the arrangements entered into under this Agreement are not intended to determine, delineate, or define:
(1) The new Health Governance Structure shall be composed of the following elements:
(1) The FNHS shall, as soon as possible after execution of this Agreement, take the necessary steps to establish the FNHA, a non-profit legal entity, representative of and accountable to BC First Nations that will reflect a structure to be developed by BC First Nations through a community engagement exercise. It shall be constituted with the good governance, accountability, transparency and openness standards which are set out in Schedule 4 or such other standards as are consistent with or exceed those standards.
(2) The FNHA shall, among other things:
(3) The FNHA may undertake other functions, roles and responsibilities connected to health and wellness of First Nations and other aboriginal people in BC.
(4) The FNHS shall act as the interim FNHA provided that the FNHS meets the minimum criteria set out in subsections 4.2(1) and (2) prior to undertaking that role.
(5) Following community consultation the FNHC may conclude that the FNHS shall act as the FNHA on a permanent basis or that for operational reasons a different legal entity should be constituted as the FNHA. In this latter case, the Parties undertake to take all steps necessary to ensure a seamless successorship from the FNHS to the new entity. These steps shall include such new entity becoming a Party to this Agreement or otherwise taking legally binding steps to adopt the obligations that are set out for the FNHA in this Agreement and the consequent release of the FNHS from such obligations.
(6) Successorship under subsection 4.2(5) is restricted to a successor legal entity that itself meets the minimum criteria established under subsections 4.2(1) and (2) and may include a statutory body.
(1) A Tripartite Committee shall be established which will be co-chaired by the following: Deputy Minister of the BC Ministry of Health, the Assistant Deputy Minister of HC/FNIHB and the Chairperson of the board of the FNHA. The membership of the Tripartite Committee will also include the following persons or their delegates:
(2) The Parties shall ensure that the Tripartite Committee performs the following functions:
(1) The FNHC is an unincorporated association composed of fifteen (15) members. It is a political and advocacy organization, representative of and accountable to BC First Nations, with a mandate to serve as the advocacy voice of BC First Nations in achieving their health priorities and objectives.
(2) The FNHC undertakes the following support and advocacy functions for and on behalf of BC First Nations consistent with its mandate, including:
(3) The FNHC may, with the approval of BC First Nations, alter its structure and mandate without the consent of the Parties, provided that it continues to fulfill the roles and functions set out in subsections 4.4 (1) and (2).
(1) The FNHDA is a society under the BC Society Act with members representing the Vancouver Coastal, Vancouver Island, Fraser, Interior and North regions of British Columbia.
(2) The FNHDA has a mandate, inter alia, to:
(1) The FNHC may advise the FNHA in a manner consistent with the FNHC's mandate but shall not direct or purport to direct the FNHA.
(2) Members of the FNHA shall act in accordance with the FNHA constitution and by-laws of the FNHA and shall not participate in the day-to-day decision-making and operations of the FNHA.
(3) The FNHDA may advise the FNHA in regard to matters which are consistent with its mandate but it shall not direct or purport to direct the FNHA.
(4) The Tripartite Committee may advise each of the Parties and the FNHA in regard to matters which are consistent with its mandate, but it shall not direct or purport to direct the Parties or the FNHA.
The FNHA shall:
(1) commence negotiations with Canada immediately following the signing of this Agreement, and make best efforts to conclude within two (2) years of the signing of this Agreement or such later time as the FNHA and Canada agree, the Sub-Agreements and the Canada Funding Agreement in order to effect, facilitate and support the Transfer of Federal Health Programs; and
(2) negotiate any funding agreements that may be offered by British Columbia.
(1) The FNHA shall prepare an annual Interim Health Plan that sets out its start-up plans, goals, priorities, program plans and services, health performance standards, anticipated allocation of resources and the use of funding to be provided by Canada and British Columbia. This Plan shall be provided by the FNHA to its members, Canada and British Columbia.
(2) The Interim Health Plan shall be prepared taking into account such advice and inputs set out in section 5.3(4) as are available at the time of drafting and shall reflect that the Transfer of Federal Health Programs may occur in stages.
(3) The Interim Health Plan shall be prepared on an annual basis until such time as the Transfer of Federal Health Programs is substantially complete.
(1) Upon expiry of the final Interim Health Plan, the FNHA shall present a five (5) year MYHP that sets out its goals, priorities, program plans and services, health performance standards, anticipated allocation of resources and use of funding to be provided by Canada and British Columbia.
(2) The MYHP shall be updated yearly and may be amended from time to time. A copy of the update and any amendments shall be provided by the FNHA to its members, Canada, and British Columbia. Canada or British Columbia may disclose the MYHP in accordance with applicable freedom of information or access to information legislation and will inform the FNHA of any request for access to the MYHP and give the FNHA the opportunity to propose limits to the disclosure in accordance with the relevant legislation.
(3) The MYHP shall:
(4) The MYHP shall take into account:
The FNHA shall prepare a summary service plan that will reflect the current health plan as outlined in section 5.2 or 5.3 and an Annual Report for its members on all of its activities, revenues, expenditures, achievements, and challenges for each fiscal year and its planning for the same matters for the following fiscal year. The summary service plan and Annual Report shall be provided to Canada and British Columbia and made available to the public.
The requirements for Interim Health Plans, the MYHP, summary service plan and the Annual Report may be further specified or varied on the consent of all Parties by way of terms to be contained in funding agreements entered into between the FNHA and Canada or the FNHA and British Columbia, and shall not require an amendment to this Agreement.
The Parties are committed to establishing a new and enduring relationship, based on respect, Reciprocal Accountability, collaboration, and innovation, that is conducive to the pursuit of improved health and wellness for First Nations in BC. Within this new relationship, the Parties have distinct but interrelated roles as described below.
(1) The FNHA shall:
(1) British Columbia shall create and support the operations of the Tripartite Committee forthwith after execution of this Agreement in accordance with section 4.3 and will direct all BC Health Authorities to participate on this Committee.
(2) British Columbia shall, as soon as practicable following creation of the FNHA:
(1) Canada shall, under the Canada Funding Agreement, provide funding to the FNHA to support the Transfer of Federal Health Programs. The Transfer of Federal Health Programs shall occur in phases or blocks as the FNHA and Canada agree and shall be completed within two (2) years of the signing of this Agreement, or such later time as both Canada and the FNHA agree. In this Agreement, a "Transfer of Federal Health Programs" means:
(2) Canada shall negotiate and make best efforts to conclude the Canada Funding Agreement for any Transfer of Federal Health Programs, and to amend the Canada Funding Agreement as necessary for any subsequent Transfer or Transfers of Federal Health Programs, provided that:
(3) Canada shall, during the period of time from the signing of this Agreement until the date or dates for the Transfer of Federal Health Programs to the FNHA, maintain the budget allocation to the HC/FNIH Regional Office for the First Nations and Inuit Health program at a level no less than that of the allocation in the fiscal year of the signing of this Agreement.
(4) Canada shall establish the Interim Management Committee and undertake the functions set out for the HC/FNIH Regional Office as part of that committee in section 7.3.
(5) Canada shall provide funding to the FNHA subject to and in accordance with sections CF 10, CF 11 and CF 12 of Schedule 1.
(1) As soon as practicable after the signing of this Agreement, the Parties shall establish an Implementation Committee with the mandate to provide general planning and coordination, as directed by the Parties, for the implementation of this Agreement over a five (5) year period. Canada, British Columbia, the FNHC and the FNHS shall each appoint a representative to the Committee. This Committee shall act on consensus and may establish sub-committees and add members as it deems necessary.
(2) The Parties intend that the Implementation Committee will take all steps reasonably necessary to advance the planned transfer and integration process set out in this Agreement based on the consensus of the committee members, including but not limited to:
(1) The Implementation Committee shall establish a Transition Team to develop a transition plan for the Transfer of Federal Health Programs. The Transition Team will include a senior officer of the FNHS or FNHA, and of the HC/FNIH Regional Office. The Transition Team shall coordinate activities associated with the Transfer of Federal Health Programs and may modify the transition plan as necessary.
(2) The Transition Team will dissolve on the date of the completion of the Transfer of Federal Health Programs.
(1) Following the signing of this Agreement, an Interim Management Committee will be formed consisting of the Regional Director of the HC/FNIH Regional Office and an individual designated by the FNHS. This Committee will review and discuss all significant and strategic level management, program or policy issues that would be decided on by the Regional Director of the HC/FNIH Regional Office and attempt to reach agreement thereon. These discussions will happen, where possible, prior to the Regional Director making a decision. The Interim Management Committee will meet as frequently as required but no less than two times per month.
(2) The Interim Management Committee will also establish a senior management team made up of the senior managers of the HC/FNIH Regional Office and the new senior managers of the FNHA. This senior management team will facilitate transition and learning by FNHA managers of the functions, operations and procedures of the HC/FNIH Regional Office to be assumed by the FNHA. Such transition and learning shall include opportunities to meet with representatives of HC/FNIHB in Ottawa. The senior management team will also work closely with the Transition Team and support the implementation of the transition plan.
(3) The Interim Management Committee will dissolve on the date of the completion of the Transfer of Federal Health Programs.
(1) Members of the Implementation Committee, Transition Team, the Interim Management Committee and the senior management team who are not officers of Canada shall be required to sign any confidentiality and non-disclosure agreements reasonably required by Canada.
(1) Canada will contribute funding support for the implementation and transition costs of the FNHS required to establish the FNHA and its operations and to transition programs, services, and functions to its management. Canada will provide a one-time payment or payments of up to $17 million to the FNHS to contribute to such costs upon the signing of this Agreement and pursuant to a funding agreement or agreements to be negotiated by Canada and the FNHS in accordance with section CF 13 of Schedule 1.
(1) Canada agrees that the FNHA may have access to administrative, program and professional officers and specialists of Health Canada for the purposes of their providing advice or other support to the FNHA in a manner to be agreed between the FNHA and Canada.
(1) In order to support the functioning and implementation of this Agreement, the Parties agree to convene the following meetings:
(2) The commitments made in this section may be amended and varied from time to time with the consent of the affected Parties.
(1) In the event of an unforeseen circumstance of a health emergency or natural disaster which would have a significant capacity or financial impact on the FNHA, Canada and British Columbia shall, with the FNHA, jointly assess the impact and required measures to address the situation. Any agreement to provide new funding or other assistance to the FNHA will be made by the Parties in writing.
(1) British Columbia commits to engage in a tripartite collaborative process to assess whether there is a need to enshrine any authorities and powers for the FNHA in provincial legislation or regulation. If all of the Parties agree that such a need exists, the BC Ministry of Health will seek to obtain the necessary legislative or regulatory changes.
(2) Canada commits to explore ways to acknowledge and express support for implementation of this Agreement through federal legislation.
(1) The BC Ministry of Health and the FNHA shall explore and identify measures, including possible legislative and regulatory mechanisms that might be of assistance to address matters of population and public health for the purposes of this Agreement consistent with the goal of this Agreement to build a more integrated health system that serves to help improve the health and well-being of First Nations and their communities in British Columbia.
(1) The Parties have agreed, pursuant to a separate letter of understanding to be reached by December 30, 2011, to enter into a discussion process regarding MSP premiums established under the Medicare Protection Act paid on behalf of Status Indian people in British Columbia.
(1) The Parties shall jointly evaluate the implementation of this Agreement every five (5) years. This evaluation shall consider the purpose and intent of this Agreement as set out in the Recitals and section 2 and be carried out within the wider context of the health partnership with BC First Nations.
(2) The Parties shall, within eighteen (18) months of the signing of this Agreement, prepare an evaluation plan and begin collecting data and reports to track at least the following:
(3) A tripartite evaluation report will be finalized within one year following the first five year period of the Transfer of Federal Health Programs. The report shall be made public.
(1) The Parties are committed to working collaboratively to develop harmonious working relationships and to prevent, or alternatively, to minimize disputes about their respective rights or obligations under this Agreement. To that end, the Parties will:
(2) The Parties nevertheless acknowledge that disputes may arise about their respective rights or obligations under this Agreement and agree that they will strive to resolve any such disputes in a non-adversarial, collaborative and informal atmosphere.
(3) If a dispute arises in relation to the respective rights and obligations of any Party under this Agreement, the Parties to that dispute shall each nominate a representative who shall promptly and diligently make all reasonable, good faith efforts to resolve the dispute.
(4) Where a dispute is between fewer than allof the Parties, those Parties involved in the dispute will inform the other Party and may ask the other Party to assist them in attempting to resolve the dispute. Any Party asked to assist may accept or decline such a role in its sole discretion.
(5) Nothing prevents the Parties, at any stage of a dispute, from agreeing to refer the dispute to mediation on such terms as they may agree. In the event that a dispute is referred to mediation, the Parties will share equally in the fees and expenses of the mediator and will otherwise bear their own costs of participation in the mediation.
(6) All information exchanged during this dispute resolution process shall be regarded as "without prejudice" communications for the purpose of settlement negotiations and shall be treated as confidential by the Parties and their representatives, unless otherwise required by law. However, evidence that is independently admissible or discoverable shall not be rendered inadmissible or non-discoverable by virtue of its use during the dispute resolution process.
(7) Before a dispute is submitted to a court of competent jurisdiction, the principals of the Parties shall be notified of the dispute and given a final opportunity to consider a resolution thereof.
(1) Subject to subsection 11.1(7), if any Party to the dispute determines that the dispute cannot be resolved under section 11.1, the dispute may be submitted by that Party to a court of competent jurisdiction.
(1) The Parties intend this Agreement to be a long term arrangement which may be updated and amended from time to time. However, any Party may terminate this Agreement by providing at least eighteen (18) months written notice to the other Parties.
(2) Upon delivery of a termination notice by any Party under section 12.1(1), the Party providing notice shall offer to host a meeting with the other Parties within one month, at which time all Parties shall attend with an appropriate official to consider whether there is any basis to continue with this Agreement in whole or in part, and with what changes or amendments as may be necessary for that purpose.
(3) The Parties, or any two of them, together with such other persons or parties as may be deemed appropriate by the participating Parties, may also meet as necessary to consider whether any parts of the arrangements put in place under or as a result of this Agreement may be continued under new or alternative arrangements between all or some of the Parties and with any new parties, as the case may be, and on what terms.
(4) At any time following the delivery of a termination notice, the Party serving it may, with the consent of all of the other Parties:
(1) In the event that there is no agreement within six (6) months or such further time as all Parties agree following the delivery of a termination notice under s. 12.1(1):
the Parties shall notify the principals of the Parties of the pending termination so as to provide them with a final opportunity to consider whether there is any basis to continue with this Agreement or to develop alternative arrangements.
(2) In the absence of any agreement by the principals of the Parties to continue with this Agreement or to new or alternative arrangements under 12.2(1), the Minister of Health (Canada) shall, subject to obtaining appropriate authority and consistent with section 12.3, provide or fund the provision of such health programs and services for First Nations in British Columbia as are consistent with Canada's First Nations health programs and policies in existence at the time of termination of this Agreement and from time to time thereafter.
(3) For greater certainty, if this Agreement is terminated, British Columbia shall not therefore be responsible for programs and payments transferred by Canada to the FNHA.
Following the provision of a notice of termination under section 12.1(1) and up to the time that any new arrangements are put in place under sections 12.1 or 12.2, the Parties shall:
For greater certainty, termination of this Agreement alone shall not cause or result in the termination of the Transformative Change Accord: First Nations Health Plan (2006), the First Nations Health Plan MOU (2006) or the Tripartite First Nations Health Plan (2007).
(1) This Agreement is intended to provide BC First Nations, through the FNHA, with a framework for undertaking the planning, design, management and delivery, and funding the delivery, of FN Health Programs in accordance with its terms and subject to the laws of British Columbia and Canada.
(2) This Agreement is not a self-government agreement and does not transfer or confer any law-making powers from or to any Party or to the FNHA.
(1) This Agreement is legally binding in accordance with its terms and represents the entire legal agreement among the Parties in respect of its subject matter.
(1) This Agreement may be amended in writing signed by duly authorized representatives of each of the Parties.
(2) An amendment to this Agreement takes effect on a date agreed to by the Parties to the amendment, but if no date is agreed to, on the date that the last Party required to consent to the amendment gives its consent.
(1) No provision of this Agreement, and no performance obligations by a Party under this Agreement, may be waived unless the waiver is in writing and signed by the Party or Parties giving the waiver.
(2) No waiver referred to in subsection (1) shall be deemed to constitute a waiver of any other provision, obligation or default.
(1) This Agreement shall be construed in accordance with the laws of the Province of British Columbia and all federal laws applicable therein. All actions or activities of the Parties undertaken pursuant to this Agreement shall be subject to the laws of the Province of British Columbia and all federal laws applicable therein.
(2) For greater certainty, the Parties recognize that neither Canada nor British Columbia has the authority, through this Agreement, to bind Parliament or the Legislature from amending federal or provincial legislation or regulations, respectively, with the possible effect of superseding this Agreement in part, or in its entirety.
Each reference to an enactment is deemed to be a reference to that enactment, and to the regulations made under that enactment, as amended or re-enacted from time to time.
It is understood that certain of the statutory, corporate, government or other bodies or organizations, including government branches, agencies or titled positions referred to in this Agreement may undergo changes to their names, functions or mandates from time to time or may cease to operate or exist. In these circumstances, the Parties agree to work cooperatively to amend this Agreement as necessary to keep this Agreement current and relevant in the face of such change, and otherwise agree that this Agreement should be given a contextual interpretation, so that such changes do not frustrate the purpose and intent of this Agreement if they are non-material or if the Parties can easily adapt their procedures to suit the new circumstances and without prejudice to any Party.
The insertion of headings and the division of this Agreement into sections are for convenience of reference only and shall not affect the interpretation thereof. In this Agreement, words importing the singular include the plural and vice versa and words importing gender include all genders. All references to the word "including" shall mean "including without limitation". All references in this Agreement to either "Canada" or "British Columbia" shall be interpreted so as to include, where appropriate, its duly authorized representative.
Each of the Parties shall from time to time and within a reasonable time execute and deliver all such further documents and instruments and do all acts and things as the other Parties may reasonably require to effectively carry out or to better evidence or perfect the full intent and meaning of this Agreement.
A Party may not assign this Agreement without the prior written consent of the other Parties. This Agreement shall enure to the benefit of and shall be binding upon the Parties and their respective successors and permitted assigns. This provision is without prejudice to the provisions of section 4.2(5).
(1) Subject to subsection (3), nothing in this Agreement shall be deemed to constitute any Party, or the FNHA, a legal partner or agent of any other Party. Each Party will act on its own behalf and not on behalf of any other Party and at no time will any Party or the FNHA hold itself out to be the legal agent, employee or partner of any other Party. No Party hereto shall have the express or implied right or authority to assume or create any obligation on behalf of or in the name of any other Party, or to bind any other Party to any contract, agreement or undertaking with any other person.
(2) For greater certainty, none of the Parties to this Agreement shall be responsible or liable for:
(3) Nothing in this Agreement shall prevent any Party or the FNHA from acting as a legal partner or agent of another for any purpose connected to this Agreement where they expressly agree, or for any purposes unrelated to this Agreement.
If any provision of this Agreement is determined to be legally invalid or unenforceable by a court of competent jurisdiction, in whole or in part, that provision will be severed from this Agreement to the extent only of the invalidity or unenforceability and the Parties will negotiate in good faith to agree on a substitute provision that will remedy or replace the invalid or unenforceable provision and any related provisions that may be affected by the invalidity or unenforceability.
Any notice or other communication to be given to a Party under this Agreement shall be given in writing, and shall be sufficiently given if delivered personally or if sent by prepaid registered mail or fax to such Party as follows:
Name: Assistant Deputy Minister, First Nations and Inuit Health Branch, Health Canada
Address: 200 Eglantine Driveway, Tunney's Pasture, Ottawa, Ontario K1A 0K9
Attention: Assistant Deputy Minister, First Nations and Inuit Health Branch, Health Canada
To British Columbia:
Name: Assistant Deputy Minister, Population and Public Health, Ministry of Health
Address: 4-2, 1515 Blanshard St, Victoria BC, V8W 3C8
Attention: Assistant Deputy Minister, Population and Public Health, Ministry of Health
To the FNHS: Name: Chief Executive Officer
Address: 1205-100 Park Royal South, West Vancouver BC V7T 1A2
Attention: Chief Executive Officer
or at such other address as the Party to whom such notice is to be given shall have last notified to the Party giving the same in the manner provided in this section. Any notice personally delivered to a Party shall be deemed to have been given and received on the day it is so delivered at such address. Any notice mailed to a Party shall be deemed to have been given and received on the fifth business day next following the date of its mailing provided no postal strike is then in effect or comes into effect within five business days after such mailing. Any notice transmitted by fax shall be deemed to be given and received on the day of its transmission.
(1) Each Party represents and warrants that it has the necessary power, authority and capacity to enter into this Agreement and that its signatory has been duly authorized to sign this Agreement on its behalf.
(2) Following the initialling of this Agreement, BC First Nations will participate in a nation-based ratification process for the governance structure, functions, and relationships of a new First Nations health governance structure. This process will require a resolution of support ratifying this Agreement at a First Nations Health Council Assembly.
The Schedules to this Agreement consist of:
This Agreement may be executed and delivered by fax and in counterparts, and each counterpart when so executed and delivered shall be deemed original.
The Parties have executed this Agreement.
Her Majesty The Queen In Right Of Canada, as represented by the Minister of Health
Honourable Leona Aglukkaq
Minister of Health
Government of Canada
Ian Potter, Witness
Chief Federal Negotiator
Government of Canada
The First Nations Health Society
Norman Joseph ("Joe") Gallagher
CEO, First Nations Health Society
Pierre Leduc, Witness
Chair, First Nations Health Society
Her Majesty The Queen In Right Of The Province Of British Columbia, as represented by the Minister of Health
Honourable Michael de Jong
Minister of Health
Province of British Columbia
Graham Whitmarsh, Witness
Deputy Minister of Health
Province of British Columbia
The First Nations Health Council
Grand Chief Douglas Colin ("Doug") Kelly
Chair, First Nations Health Council
Shawn A-in-chut Atleo, Witness
National Chief, Assembly of First Nations
CF 1. General: Canada will transfer an "Annual Federal Amount" to the FNHA under a Canada Funding Agreement to be negotiated in accordance with the terms of this Schedule. The Annual Federal Amount will be calculated in accordance with section CF 3 and be transferred for the purposes set out in the Interim Health Plan or Multi-Year Health Plan. The Annual Federal Amount will be paid toward all of the costs to be incurred by the FNHA for the delivery of its Interim Health Plan or Multi-Year Health Plan, inclusive of all related corporate and administrative expenses of any kind including employee pay and benefits, policy and program costs.
CF 2. Term: The Canada Funding Agreement will have a term of 10 (ten) years with funding amounts, program delivery and reporting functions organized on an April 1-March 31 "fiscal year" basis. The Canada Funding Agreement may be entered into at once or in stages for all or part of the Annual Federal Amount.
CF 3. The Annual Federal Amount: The Annual Federal Amount shall be calculated as follows:
CF 4. Base Year Amount: The "Base Year Amount", which has been calculated with reference to the total direct, indirect, support and administrative costs of Canada for funding, providing and administering all Federal Health Programs, is the "2008/9 amount" of $318,832,400 as set out in Annex A, Table 1, plus the Adjustment Factor set out in section CF 5.
CF 5. Adjustment Factor: The 2008-09 amount in section CF 4 will be adjusted to the effective date or dates of the transfer of funding for Federal Health Programs to the FNHA to become the Base Year Amount by way of the following adjustment factor ("Adjustment Factor"):
If any of the programs referred to in (a) to (c) above are transferred in parts and in separate years, the funding for each part will be based on the funding level for the relevant year of transfer set out above.
CF 6. Annual Escalator: The Canada Funding Agreement will provide for fixed annual increases ("Annual Escalator") of 5.5% to the prior fiscal year's Annual Federal Amount (annualized) in fiscal years two (2), three (3), four (4) and five (5) of the Canada Funding Agreement provided that, and during the time that, the NIHB Program is included in the programs transferred to the FNHA pursuant to this Agreement. For any period of time during the above-noted fiscal years that the NIHB Program is not included in the programs transferred to the FNHA, the Canada Funding Agreement will provide for fixed annual increases of 4.5% to the prior year's Annual Federal Amount (annualized). Canada and the FNHA will commit to negotiate an Annual Escalator for the remaining fiscal years of the Canada Funding Agreement in accordance with subsections CF 3(c) and CF 9(a).
CF 7 Funding Flexibility: The Canada Funding Agreement will provide for flexibility in the allocation of resources and in the design and prioritization of programs. The Annual Federal Amount will not be reduced by any of the following:
CF 8. Reporting: The FNHA will:
This evaluation will be available to the FNHA members, Canada, British Columbia and the public.
CF 9. Renewal Procedures: Canada and the FNHA will review the funding and other provisions of the Canada Funding Agreement during its term as part of their regular review of that agreement and will plan for the update and renewal of that agreement as follows:
CF 10. New Programs and Services Funding
(1) The FNHA and Canada shall enter into discussions with respect to accessing any available federal funding for any new health or related programs, including any environmental remediation programs, and services which may be introduced by Canada from time to time on a national or regional basis.
(2) Additional funding will not be provided in respect of: (a) new federal health programs, services or operations which substantially replace any Federal Health Programs set out in Schedule 3 or for which funding has already been provided under an agreement between Canada and the FNHA; (b) national or regional funding changes for Federal Health Programs set out in Schedule 3 or substantially similar programs or their operations.
(3) Notwithstanding subsection CF.10(2), in the event that Canada introduces expanded beneficiary eligibility and associated funding for any federal health programs and services set out in Schedule 3 as a result of possible legislative amendments to the Indian Act (Canada) or decisions of the courts that result in an increased number of persons eligible to be registered as an Indian under that Act, Canada and the FNHA will work together to determine impacts and approaches to address such change. The FNHA and Canada shall enter into discussions with respect to accessing any federal funding that is made available nationally for any new or expanded programs or services to address such eligibility matters.
CF 11. Indian Residential Schools Program (IRS Program) Funding: Canada will provide funding to be paid on a time limited basis (not to exceed the duration of the IRS Program) pursuant to a funding agreement or agreements to be negotiated between Canada and the FNHA for the purpose of delivering the IRS Program. Such funding will be provided pursuant to a funding agreement or agreements to be negotiated by Canada and the FNHA in accordance with section CF.13.
CF 12. Top-Up Funding for the TFNHP: Canada will provide an additional annual contribution to the FNHA to be paid on a time limited basis, and if required, to ensure that the value of the federal contribution to the TFNHP in each full fiscal year of the Canada Funding Agreement is $10 million. The base amount for the TFNHP which is included in the Base Year Amount, is $6 million in 2008-9 fiscal year funds. When that amount, as adjusted by the applicable Adjustment Factor in section CF 5 and the Annual Escalator in section CF 6, reaches $10 million, the top-up will cease. Such top-up funding will be provided pursuant to a funding agreement or agreements to be negotiated by Canada and the FNHA in accordance with section CF 13.
CF 13. General Terms and Conditions:
(1) Each funding agreement to be entered into by Canada and the FNHA or the FNHS pursuant to this Agreement shall contain such terms and conditions as the two Parties may negotiate provided that such terms and conditions, and the manner of payments to be made under the agreement, are consistent with federal Treasury Board policy and applicable laws, including the following:
CF 14. Funding Role of the FNHA - Funding First Nation Health Providers:
The Canada Funding Agreement shall provide that where the FNHA acts as a funder of First Nation Health Providers in respect of FN Health Programs it shall:
CF 15. Self-Governing First Nations:
(1) The FNHA may provide FN Health Programs to Self-Governing First Nations and may conclude arrangements including funding agreements to deliver such programs and services to any Self-Governing First Nation in whole or in part.
(2) Notwithstanding any other provision of this Schedule if:
then the Annual Federal Amount shall be reduced by the value of the terminated FN Health Programs described in (a) as determined by Canada in consultation with the FNHA and the affected Self-Governing First Nation.
Annex A (Details of Canada Funding) contains certain 2008/9 budget information for Federal Health Programs. It is attached to this Schedule for use with reference to CF 3, CF 4 and CF 5 and for reference purposes only. In the event of a conflict or inconsistency between Annex A and this Agreement or Schedule, the terms of this Agreement and the Schedule, in that order, shall prevail.
to Schedule 1 (Canada Funding) of the British Columbia Tripartite Framework Agreement on First Nation Health Governance
Details Of Canada Funding
|Regional Community Programs||$127,656,800|
|Tripartite First Nations Health Plan||$6,000,000|
|Regional Sun-setting Programs||$16,807,800|
|Non-Insured Health Benefits Program||$135,520,700|
|Policy and Program Leadership (FNIHB HQ)||$7,819,300|
|Corporate and Management Services (includes EBP)||$12,839,900|
|Total Base Year Amount||$318,832,400|
|Implementation Funding (one-time funding)||$17,000,000|
|All programs transferred||5.5%|
|NIHB not transferred||4.5%|
|Tripartite Health Plan Top Up (in 2008-09 value)||$4,000,000 *|
* Payment starting in transfer year to top up amount to $10,000,000
|Program Components||Adjustment Factor
Summary Elements For 2008-09
($ 000 thousands)
|Regional Community Programs + Tripartite Health Plan||133,656.8||0||0||133,656.8|
|Non-Insured Health Benefits (NIHB)||0||135,520.7||0||135,520.7|
|FNIHB HQ Policy and Programs||5,158.0||2,661.3||0||7,819.3|
|Corporate and Management||7,705.6||596.1||0||8,301.7|
|Employee Benefit Plan||4,238.6||299.6||0||4,538.2|
|Program Components||Adjustment Factor
Summary Elements For 2010-11
($ 000 thousands)
|Regional Community Programs + Tripartite Health Plan||139,061.3||0||0||139,061.3|
|Non-Insured Health Benefits (NIHB)||0||151,264.3||0||151,264.3|
|FNIHB HQ Policy and Programs||5,246.9||2,681.5||0||7,928.4|
|Corporate and Management||7,843.0||608.5||0||8,451.5|
|Employee Benefit Plan||4,375.9||326.9||0||4,702.8|
|Program Components||Adjustment Factor
Summary Elements For 2011-12
($ 000 thousands)
|Regional Community Programs + Tripartite Health Plan||141,881.8||0||0||141,881.8|
|Non-Insured Health Benefits (NIHB)||0||159,807.8||0||159,807.8|
|FNIHB HQ Policy and Programs||5,292.4||2,691.8||0||7,984.2|
|Corporate and Management||7,913.1||614.9||0||8,528.0|
|Employee Benefit Plan||4,446.1||341.1||0||4,787.2|
|Program Components||Adjustment Factor
Summary Elements For 2012-13
($ 000 thousands)
|Regional Community Programs + Tripartite Health Plan||144,784.2||0||0||144,784.2|
|Non-Insured Health Benefits (NIHB)||0||168,832.5||0||168,832.5|
|FNIHB HQ Policy and Programs||5,338.5||2,702.3||0||8,040.8|
|Corporate and Management||8,020.8||621.4||0||8,642.2|
|Employee Benefit Plan||4,517.3||355.5||0||4,872.8|
|Program Components||Adjustment Factor
Summary Elements For 2013-14
($ 000 thousands)
|Regional Community Programs + Tripartite Health Plan||147,770.9||0||0||147,770.9|
|Non-Insured Health Benefits (NIHB)||0||178,367.6||0||178,367.6|
|FNIHB HQ Policy and Programs||5,385.4||2,712.9||0||8,098.3|
|Corporate and Management||8,117.2||628.0||0||8,745.2|
|Employee Benefit Plan||4,589.6||370.6||0||4,960.2|
(1) British Columbia will provide funding to the First Nations Health Society (FNHS) to implement the commitments in the Transformative Change Accord: First Nations Health Plan (TCA:FNHP) and the Tripartite First Nations Health Plan (TFNHP), as described below:
|Fiscal Year||Annual Funding Amount|
(2) British Columbia's obligation to provide funding under this Agreement is subject to the BC Financial Administration Act, which makes that obligation subject to an appropriation being available in the fiscal year of the Province of BC during which payment becomes due.
(3) This funding will be re-directed to the FNHA upon its creation and the same conditions will apply.
(4) In the event of termination of this Agreement, the BC Ministry of Health will pay the amounts described above to the FNHS or other agency. The conditions of payment shall be governed instead by the principles of the TCA:FNHP and the TFNHP. The FNHS and the BC Ministry of Health will enter into good faith negotiations during the eighteen (18) month notice period to enter interim and final agreements in respect of the deliverables, funding and other matters respecting the goals of the funding as described in the above documents and this schedule. There will be no payments until an agreement is reached.
(5) The FNHS will provide to British Columbia the following reports, in the form and manner proscribed by British Columbia:
Annual Funding Letter and Payment Schedule
(6) Each year British Columbia shall review the updated IHP and the MYHP as identified in section 5.2 and 5.3 of this Agreement and the annual spending plan identified above. Upon completion of this review, British Columbia shall issue to the FNHS an annual funding letter that will include a payment schedule showing how the annual funding amount will be paid by British Columbia to the FNHS.
1. Federal Health Programs as of the date of this Agreement comprise the following which are more particularly described in the Health Canada First Nations and Inuit Health Compendium (2007):
2. Only those programs listed in section 1 are Federal Health Programs for the purposes of this Agreement. The Parties acknowledge that certain of the health programs and services or components thereof which are listed in the Health Canada First Nations and Inuit Health Compendium (2007) are not included in the Transfer of Federal Health Programs under this Agreement. In particular, programs and services set out in the Compendium which are excluded from the purview of this Agreement include:
The FNHA shall ensure that its constitution, by-laws, policies and procedures will be based on standards that are at least consistent with, and otherwise exceed those set out below, subject to applicable incorporation legislation:
FNHA Corporate organization and separation of functions
(1) The FNHA shall have at least the following corporate and organizational elements and characteristics:
(2) The FNHA shall operate according to the following characteristics and principles regarding its planning, performance and evaluation processes:
Budgets / strong financial control / monitoring and audit systems
(3) The FNHA shall have strong internal controls systems, budgeting and allocation processes including as set out in s. 4.2(2) (k) (l) and (m) of the main body of this Agreement.
Conflicts of interest / ethics
(4) The FNHA shall have strong internal conflict of interest and ethical standards, with the following minimums:
Accountability and reporting
(5) The FNHA shall have strong internal accountability processes, with the following minimums:
(6) The FNHA shall institute risk management policies, at least consisting of:
Canada and the FNHA (for the purposes of this Schedule, the "parties") shall enter into discussions immediately following the signing of this Agreement and the creation of the FNHA with the objective of entering into all further agreements necessary to effect and support the Transfer of Federal Health Programs and the implementation of this Agreement.
The Sub-Agreements will include those set out below and such other agreements as the parties may agree. The Sub-Agreements shall contain at least the terms set out below and such other terms and conditions as the parties agree and which are consistent with law. The Sub-Agreements may also be entered into simultaneously or over time to suit the pace of transfer as may be agreed by the FNHA and Canada.
A human resources agreement or agreements to facilitate the hiring of HC/FNIH Regional Office staff by the FNHA in order to support a smooth transition of operations from Canada to the FNHA in respect of the Transfer of Federal Health Programs.
This agreement will set out provisions for, among other things, a reasonable job offer to full-time and part-time indeterminate employees as per the National Joint Council Work Force Adjustment Directive, where referenced in or incorporated into a collective agreement or a collective agreement itself contains comparable reasonable job offer provisions, or under the applicable Directive on Terms and Conditions of Employment as applicable to the employee.
A health benefits agreement to provide that the FNHA will design, plan, manage and deliver a health benefits program that replaces the NIHB Program and that includes the actions and commitments required for a smooth transition and to maintain continuity of health benefits services to clients. The health benefits agreement or agreements shall also include provision for:
A records transfer and information management and sharing agreement or agreements to facilitate the Transfer of Federal Health Programs. Such agreements shall be subject to and in accordance with applicable laws and privacy impact and threat risk assessments. Such agreements shall include provision for:
Asset, software and IP agreements for the assets used by the HC/FNIH Regional Office for the provision of Federal Health Programs and which are owned, leased or licensed by Canada. The parties shall identify and agree on all assets to be transferred (if transferable by Canada). Such transfers shall be subject to applicable laws including the Financial Administration Act (Canada) and the Surplus Crown Assets Act(Canada). Asset transfer agreements shall include provision for:
An accommodation agreement or agreements for the subletting or assumption by the FNHA of Crown-owned or leased office space currently occupied by the HC/FNIH Regional Office and used for the delivery of Federal Health Programs ("FNIH Office Space") that the FNHA wishes to assume. Such agreements shall be in accordance with law and shall include provision for:
Agreement on the responsibilities associated with funding the construction, renovation, repair, operation and maintenance of First Nations health facilities including nursing stations, health centres, nurse residences and other health support facilities located on reserve or in or near First Nation communities. Such an agreement shall include provision for:
Agreement between the parties, in respect of the Transfer of Federal Health Programs which involve the funding of First Nation Health Providers, for Canada to assign or novate affected Canada CA's with those providers to the FNHA that would otherwise be in effect on the date of such transfer. Where such assignments or novations are not possible, Canada shall terminate the affected Canada CA's on ninety (90) days notice, so that new contribution agreements can be concluded between the FNHA and First Nation Health Providers.