First Nations Health Authority

MEMORANDUM OF UNDERSTANDING 8 First Nations

Health Directors Association

FIRST NATIONS HEALTH DIRECTORS ASSOCIATION (FNHDA)

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FIRST NATIONS HEALTH AUTHORITY (FNHA)

~!~!!ose_·----------------------------------------------------------------------------------------------------· The purpose of this Memorandum of Understanding (MoU) is to describe the ongoing relationship between the FNHDA and FNHA, with particular focus on processes and commitments for regular communication between the FNHDA and FNHA, processes of collaboration between the FNHDA and FNHA on issues such as the budget process, associated funding commitments and financial accountability, and the provision of Secretariat and other corporate support by the FNHA to the FNHDA.

Background ---

In November 2005, the First Nations Leadership Council and the Governments of Canada and British Columbia signed the Transformative Change Accord committing the parties to work in partnership to improve outcomes for First Nations in BC in the areas of relationships, health, housing, education, and economic opportunities. Since 2005, the partnership between First Nations, Canada, and BC in the area of health has developed significantly, as captured in a series of further political and legal agreements:

• Transformative Change Accord: First Nations Health Plan (2006) • Tripartite First Nations Health Plan Memorandum of Understanding (2006) • Tripartite First Nations Health Plan (2007) • Basis for a Framework Agreement on Health Governance (201 OJ • Tripartite Framework Agreement on First Nation Health Governance (2011) • Provincial-level Health Partnership Accord (to be completed in 2012)

First Nations have created and mandated the First Nations Health Council to provide political oversight for the implementation of the above agreements. The FNHC created the First Nations Health Society to serve as its business and operational arm. The FNHDA is a society under the BC Society Act, composed of health directors and managers working in First Nations communities, that supports education, knowledge transfer, professional development and best practices for health directors and managers, and acts as a technical advisory body to the FNHC and FNHA on research, policy, program planning and design, and the implementation of the Health Plans. In May 2011, First Nations approved the Consensus Paper: BC First Nations Perspectives on a New Health Governance Arrangement, which called for the transition of the First Nations Health Society to an interim FNHA. The interim FNHA, which has now become the FNHA, is a society under the BC Society Act with a mandate, inter alia, to promote and advance health service issues on behalf of First Nations in British Columbia, to implement the commitments in the Transfonnative Change Accord: First Nations Health Plan (2006), the First Nations Health Plan MOU (2006) and the Tripartite First Nations Health Plan (2007).

The Consensus Paper: BC First Nations Perspectives on a New Health Governance Arrangement also clearly established the mandates and roles of the FNHC, FNHA and FNHDA in the implementation of the political and legal agreements referenced above. The FNHC, FNHA and FNHDA work in partnership in exercising their respective mandates and roles. The FNHC is responsible for political leadership and strategic direction, the FNHA is responsible for business and operations, and the FNIIDA is responsible for its mandate as described in the preceding paragraph.

Guiding Documents, Standards and Values --------.. ---------------------------·· ........ ___ .. ____ ............. _ .. _______________ _ The FNHDA and FNHA are obliged to cooperate with one another to develop a harmonious working relationship. This relationship is guided by a set of guiding documents, standards and values.

At a strategic level, the work of the FNHDA and FNHA is guided by the political and legal agreements and the Consensus Paper: BC First Nations Perspectives on a New Health Governance Arrangement referenced in the section above. Their work is also guided by resolutions passed by First Nations at Gathering Wisdom for a Shared Journey forums.

In particular, in the Consensus Paper: BC First Nations Perspectives on a New Health Governance Arrangement, First Nations established seven directives-standards to guide the work of the FNHDA and FNHA:

• Directive # l: Community driven, nation based • Directive #2: Increase First Nations decision-making • Directive#3: Improve services • Directive #4: Foster meaningful collaboration & partnership • Directive #5: Develop human and economic capacity • Directive #6: Be without prejudice to First Nations interests • Directive #7: Function at a high operational standard.

The FNHDA and FNHA have agreed to a common set of values to guide their conduct, efforts and relationships with one another and with First Nations and other partners:

• Respect: o We believe that maintaining respectful relationships is fundamental to the achievement of

our shared vision. Respectful relationships are built upon the recognition that we all have something to contribute, as individuals and as the three components of the First Nations health governance structure. Therefore, we commit to treating each other with dignity and generosity, being responsive to one another, and acknowledging that each entity has its own respective processes and practices. We are also committed to respectful interactions with First Nations, tripartite partners, and other collaborators.

• Discipline: o We have the historic opportunity to achieve transformative change in First Nations health

and wellness, and an obligation to make the most of this opportunity. This will require discipline amongst us, including through loyalty to one another and our shared vision; upholding and supporting our roles, responsibilities, decisions and processes; maintaining and nurturing unity and a united front; integrity and reliability in fulfilling our commitments, and accountability to one another for these commitments and contributions; and solutions-oriented and active participation.

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• Relationships: o We believe that effective working relationships with First Nations, tripartite partners, and

with one another are the foundation for achieving our vision and implementing our health plans and agreements. We commit to fostering effective working relationships and camaraderie underpinned by trust, honesty, understanding, teamwork, and mutual support. We also acknowledge that humour and laughter are both good medicine, and a good way to build relationships.

• Culture: o We are here because of those that came before us, and to work on behalf of First Nations.

We draw upon the diverse and unique cultures, ceremonies, customs, and teachings of First Nations for strength, wisdom, and guidance. We uphold traditional and holistic approaches to health and self-care and strive to achieve a balance in our mental, spiritual, emotional, and physical wellness.

• Excellence: o We are humbled and honoured to have been asked by First Nations to work on their

behalf to improve health and wellness, and have a moral and personal responsibility to strive for excellence. Excellence means that our outcomes are sustainable, that our processes are professional and transparent, and that we commit to learn continuously­through capacity development opportunities, from each other and from new, different and innovative models worldwide.

• Fairness: o We work to improve the health and wellness of all First Nations in BC. Our decision­

making reflects the best interests of all First Nations, and leads to just and equitable treatment amongst all First Nations communities, First Nations organizations, and across all regions of British Columbia. We are committed to make room for everyone, and are inclusive in our communications, information-sharing, and discussions.

CoUaborative Process

The FNHDA and FNHA agree to appropriately uphold their respective roles and responsibilities, and make best use of one another' s roles and strengths through the following meetings and opportunities for collaboration:

• The FNHDA will review their strategic plan describing FNHDA priorities, taking into account any recommendations from the FNHA in this regard, and work with the FNHA to discuss how the FNHDA and FNHA will work together to support the implementation of the FNHDA strategic plan;

• The FNHA Officers will be available to attend and provide reports and perspectives to FNHDA meetings, and the FNHDA Officers will be available to attend and provide reports and perspectives to FNHA Board of Directors meetings;

• The FNHA Officers will work closely with the FNHDA President and Vice President to ensure coordinated activities, strategy, and messaging and proactive problem-solving;

• The Executive Director FNHDA Secretariat will establish regularly scheduled meetings in conjunction with other FNHA Executive Directors.

Channels of Communication --------------Engaging at appropriate levels, with appropriate individuals, and in accordance with a clear process will support upholding accountability and transparency, reduce any perception of conflict of interest, and ensure the separation of politics and business.

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The first point of contact for FNHDA on strategic-level issues, requests, or questions having to do with the operations of the FNHDA or FNHA is the FNHDA President (or in the President's absence, the Vice President). Similarly, the ftrSt point of contact for FNHA Board members on strategic-level issues, questions or concerns having to do with the operations of the FNHDA or FNHA is the FNHA Chair (or in the Chair' s absence, the Vice-Chair). The President of the FNHDA and the Chair of the FNHA will coordinate with one another as needed to address the matter. Examples of strategic-level issues, questions or concerns include the relationship between the FNHDA and the FNHA, fmancial matters and accountability, and Terms of Reference or governance matters.

The first point of contact for FNHDA members on operational-level issues, requests, or questions having to do with the operations of the FNHDA or FNHA is the Executive Director-FNHDA Secretariat or appropriate designate. Similarly, the first point of contact for FNHA Board members on operational-level issues, questions or concerns having to do with the operations of the FNHDA or FNHA is the FNHA Chief Executive Officer or appropriate designate. Examples of operational-level issues, requests or questions include operations, travel and accommodations, financial matters, requests for staff support, requests for communications and similar materials.

Staff of the FNHA and FNHDA Secretariat are expected to work through their supervisor on matters relating to the FNHDA and FNHA, and not directly contact individual members of the FNHDA or FNHA Board of Directors on any issues relating to the work of the FNHDA or FNHA.

Provision of the FNHDA Secretariat

The FNHA will provide for the FNHDA a support team dedicated to the work of the FNHDA, called the FNHDA Secretariat.

The FNHDA Secretariat will include an Executive Director selected by the FNHDA and FNHA. The Executive Director FNHDA Secretariat will select additional staff for the FNHDA Secretariat as may be agreed upon by the FNHDA and FNHA.

In addition, the FNHA will provide corporate services to the FNHDA and the FNHDA Secretariat, to enable or provide additional capacity for the FNHDA to carry out its work. These corporate services include finance, human resources, information and records management, technology, community engagement, communications, administrative and coordination services, office accommodations, legal, and policy.

The legal and financial affairs of the FNHDA Secretariat will be the responsibility of the FNHA, through the office of the FNHA CEO. The CEO will identify an Executive Lead-FNHDA that will hold responsibility for working with the Executive Director-FNHDA Secretariat to support the work of the FNHDA in a manner consistent with the policies and procedures of the FNHA. The Executive Lead­FNHDA and Executive Director-FNHDA Secretariat will collaborate and work together to meet the needs of the FNHDA and the accountabilities of the FNHA in areas such as budgeting, human resources, travel and events, fmancial management, information management and information technology, policy, communications, and other corporate and central functions. In cases where the policies of the FNHA do not meet the needs of the FNHDA, the Executive Lead-FNHA and Executive Director-FNHDA Secretariat will work to find a reasonable solution.

The Executive Director-FNHDA Secretariat reports administratively to an Officer of the FNHA Board of Directors. The Executive Director-FNHDA Secretariat also has accountability to and takes functional direction from the FNHDA Board of Directors.

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~eporting and Co~~unicatio._ns ___________________________ _

Both the FNHDA and the FNHA have obligations to provide and/or support reporting to First Nations on their respective activities, roles, and responsibilities. A communications strategy will be developed by the FNHA Director of Communications in consultation with and with the approval of the FNHDA Executive.

All reporting by the FNHDA and FNHA will be at the strategic level ; the level of detail provided in reports by the FNHDA and FNHA should correspond to the level of detail of feedback and direction being sought, and maintain the separation of business from politics. Confidential or sensitive information will not be disclosed. nor will any information that may jeopardize the strategy, negotiations or business operations of the FNHDA and FNHA.

The following chart summarizes reporting obligations. This reporting is supported by the staff of the FNHA in terms of logist ics, coordination, advice, and drafting and preparation of reports in a variety of media.

Enlil~ R ~'flO rl in:! lh·porlill:,! Ohli:.,:alion and Vl·nut·(s) r, fll' of l{l'porl iug l{t·s pun ,j hi IiI y

FNHDA FNHDA members To all First Nations through regular Reporting to First Nat.ions collectively written media and Gathering Wisdom on the activities and work

forums undertaken by the FNHA FNHDA To First Nations in regions and sub- in support of the FNHDA Directors regions through regional and sub-(regional regional caucuses rep_resentati ves)

FNHA FNHA Members To all First Nations through a Reporting at a strategic published annual report and as level to First Nations on determined in regional and sub- the activities and work of reirional caucuses theFNHA

FNHA Directors To Members through Annual General Reporting on the Meetings and regular joint meetings operations of the FNHA,

including annual report and audit

FNHA Officers To all First Nations through a one Reporting on the report on an annual basis to each operations of the FNHA, Regional Caucus following the including annual report annual report and audit of the FNHA and audit

Hiring Practices ----------- ·------------

The FNHA will be the employer of all staff of the FNHA and of the FNHDA Secretariat. The following hiring approach will be taken by the FNHA when hiring new employees for positions placed within the FNHDA Secretariat.

I'OSI'IIOi\' FNIIC Hok and Hl'"porl'>ihilil~ Fi\'IIA Hok and Rl'' ponsi hi IiI~

FNHC SECRETARIAT Executive FNHDA provides direction and collaborates with the FNHA CEO (and Officers Director- FNHA for the appointment of the Executive Director- as required) work with FNHDA FNHDA Secretariat. FNHDA President and

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Secretariat Vice President to establish the arrangement.

Agreed-upon The Executive Director-FNHDA Secretariat is Senior FNHA staff works technical responsible for making arrangements for the additional with the Executive support positions within the FNHDA Secretariat (through Director-FNHDA positions internal/external competition process, secondment, or Secretariat to carry out

interchange). The FNHDA Officers may be involved in administrative and follow-shortlistin~ for any competition if desired. up functions.

FNHDA Financial Process ·-·--·-····------- -- --·----·-·-·-------··-·----·--The responsibility and accountability for financial matters related to the activities and work undertaken by the FNHA to support the FNHDA will be carried by the FNHA, through the office of the CEO, in a manner consistent with the policies and P,rocedures of the FNHA and its remuneration policies and procedures. These matters include but afe not limited to the following: budget development and adherence to budget, contract management for services and venues, and honoraria and travel reimbursement. The FNHDA will work with the FNHA on all FNHDA related financial matters as the FNHA holds the financial liabilities associated with the activities and work of the FNHDA. The FNHA will undertake a customer service approach in dealing with financial matters related to the FNHDA.

The FNHDA will work through the Executive Director-FNHDA Secretariat to bring forward financial matters to the FNHA. The Executive Director-FNHDA Secretariat will also work with the FNHDA to submit budgets to the FNHA ensuring that the FNHDA are represented in the FNHA annual budget cycle. The Executive Lead-FNHDA and Executive Director-FNHDA Secretariat will work in collaboration, within the FNHA policies, to support the needs and priorities of the FNHDA.

In cases when FNHA policies do not meet the needs of the FNHDA, the Executive Lead-FNHDA and Executive Director-FNHDA Secretariat will work to find a reasonable solution. If a financial issue cannot be resolved at this level, the FNHDA and FNHA will follow the Operational Issue Resolution Process outlined above.

Mediation and Operational Issues Management ---·----·----------···--------

FNHDA members and FNHA Board members are committed to identifying any disagreements quickly and resolving them in the most effective and expeditious manner possible, and in a non-adversarial and collaborative atmosphere. Should any disputes arise between FNHDA member(s) and FNHA Board member(s), the FNHDA Officers and the FNHA Officers will have a face-to-face meeting to attempt to resolve the dispute, calling upon other members of the FNHDA or FNHA Board for additional support as required. If a face-to-face meeting does not resolve the dispute, an elder will be engaged to facilitate a resolution to the dispute.

From time to time, issues and/or disputes may arise between the FNHDA and the FNHA at the operational level (with respect to the central services that the FNHA provides to the FNHDA, such as finance, human resources, information management, technology, and other corporate matters). When such an issue is encountered by a member of the FNHDA, that individual will bring the issue to the attention of the Executive Director-FNHDA Secretariat. The Executive Director-FNHDA Secretariat then works at the operational level within the FNHA, and particularly with the Executive Lead-FNHDA, to resolve the

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issue, relying upon the applicable policies, procedures, and standards adopted by the FNHA and with the aim of identifying common-sense and customer-focused solutions. Where the Executive Lead-FNHDA and Executive Director-FNHDA Secretariat are unable to satisfactorily resolve the issue, the senior executives of the FNHA will be called upon to assist. Where the issue is unable to be resolved by management, the issue will be brought forward to the FNHDA President and FNHA Chairperson, who will identify an acceptable solution for implementation by management.

Amendment ---------------------------

This Memorandum of Understanding may be amended by agreement of the Directors of the FNHDA and the Directors of the FNHA from time to time.

President, First Nations Health Directors Association

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