AFN Proposal for 2005 FMM on Aboriginal Issues October 19, 2005

1. AFN Proposal for 2005 FMM on Aboriginal IssuesOctober 19, 2005 The 10-Year Challenge DRAFT

2. Our Vision A ten-year plan for closing the gap in quality of life between First Nations and the Canadian population. This will be achieved by recognizing and exercising First Nations jurisdiction, creating sustainable development opportunities, building institutional capacity, and through concentrated efforts on all of the determinants of health.

3. The 10-Year Challenge • To close the gap in the quality of life between First Nations (FNs) and Canadians by: • Eradicating poverty as a matter of first priority; • Establishing 10-year goals to guide the work ahead; • Adopting a Holistic Policy and Planning Model addressing 14 key health determinants, with associated performance indicators; • Setting achievable goals, immediate priorities, realistic targets, and measurable improvements over this 10 year period; and • Obtaining a commitment to a series of FMM meetings to ensure a continuing focus on FN issues and enable the tracking of progress over time. • This is a challenge to all Leaders. A ten-year investment will yield benefits for the seven generations to come.

4. Why the “10-Year Challenge”? • Royal Commission on Aboriginal Peoples (RCAP) • Nine years later, there has been no significant measurable quality of life improvements for FNs. • UN Human Development Index (HDI) • FN populations continue to lag significantly behind the rest of Canada on this international index. • INAC Community Well-Being Index (CWI) • Using a modified form of the HDI, INAC looked at education, labour force rates, income and housing for FNs and found that: • Only 1 FN community is featured in the top 100 Canadian communities; while 92 FN communities are part of the bottom 100 Canadian communities. • Canada is signatory to the UN Millennium Declaration • One of the goals is the eradication of extreme poverty and hunger. • Speech from the Throne, February 2004 • Prime Minister recognizes the “shameful conditions” in which FNs live.

5. The Direction Forward • First Nations~Federal Crown Political Accord • promote meaningful processes for reconciliation and implementation of section 35 rights, with appropriate jurisdictions and authorities, for FN governments to achieve an improved quality of life, and to support policy transformation in other areas of common interest, affirming and having regard to a set of principles, including: • recognition of the inherent right of self-government and Aboriginal Title; • implementation of the Treaty relationship; • compliance with the Crown’s fiduciary responsibilities; • human rights, and • improved socio-economic development. • The UN Human Development Report confirms that transformative change be achieved by restructuring the underlying social and economic framework. • Harvard Project (2002-03) and Chandler and Lalonde (1998) report that self-government is the key to economic self-sufficiency and improved health. • First Ministers must commit to the recognition and implementation of FN governments in order to meaningfully affect the status quo.

6. The “Health Determinants” Perspective • AFN has advocated for the adoption of a population health approach to planning for the 2005 FMM with FN self-government as the underpinning framework. • AFN proposal of a First Nations Holistic Policy and Planning Model based on national/international models to maximize the positive impact of potential new investments and partnerships from this 2005 FMM. • The Holistic Model aims to address the root causes of poverty and other disparities. • The Model further supports the AFN conclusion that one FMM will not be sufficient to deal with all relevant determinants of FNs’ health and well-being.

7. AFN Holistic Policy and Planning Model

8. 1. Relationships The Challenge • Implementation of the proposed FN-specific FPT Multilateral Accord. • Specific regional FN/PT agreements. • Capacity/Sustainability • Funding matched to population growth and real cost drivers. • Holistic Approach: • Interconnectedness of all 14 health determinants. The Targets • A series of FMMs over 10 years, involving the AFN National Chief, dedicated to the remaining Health Determinants. • A “full” seat at the table at First Ministers and sectoral meetings potentially affecting FNs. • Promote FN/FPT processes aimed at renewed policy frameworks building upon existing regional processes/agreements. The Outcome • Recognition and Implementation of FN Governments.

9. 2. Health Blueprint The Challenge • Improved health outcomes for FNs. • Under FN-Federal Crown Political Accord and proposed Multilateral Accord, Implementation of FN jurisdiction in health care and public health. • Implementation of treaty right to health. • Strengthening a distinct yet interdependent FN health system. • Expanding current service and program provisions to emphasize the needs of children, youth, and persons with disabilities. The Targets • FN Health Authorities, with a comprehensive primary care model, public health capacity and holistic health strategy. • Needs-based health escalator. • Reform of NIHB and end to its “payer of last resort” policy. • Expanded continuing care (long-term & palliative care). • FN Health Human Resources Strategies. • National Network of FN Health Information & Research Centres. • Actions to clarify roles and responsibilities (per Sept/04 Communiqué). • Direct FN involvement decision-making regarding allocation of $700M announced September 2004.

10. Health Blueprint: Outcomes • 11% annual escalator. • Capacity funding for FN Health Authorities. • Higher quality and improved efficiency of access for eligible FN to non-insured health benefits. Removal of NIHB Payer of Last Resort Policy. • Catastrophic and expensive drug coverage. • Flexibility to plan and implement community health programs based on needs versus rigid reporting frameworks. • Larger percentage of FN Elderly cared for in their homes. • Moratorium on personal care homes on-reserve lifted. • Competitive wages for health professionals and para-professionals working in FN communities. • Telehealth services in more than 200 FN communities. • Minimum of 10 FN health info/research centres to obtain comprehensive data on health outcomes and health determinants.

11. 3. Education The Challenge • Improved educational performance for FN learners to levels comparable to national and international cohorts. • Under the FN~Federal Crown Political Accord and proposed Multilateral Accord, recognize and implement FN jurisdiction over education and the treaty right to Lifelong Learning. • P/T partnership with FN governments in areas of overlapping and complementary jurisdiction. • Support FN right to language and culture education as integral to educational programming. The Targets • Implementation of FN education systems. • Enabling frameworks (i.e., legal, policy and fiscal). • Interface of FN and PT systems. • FN-P/T equivalency and mutual accountability frameworks, as appropriate. • Adequate resourcing of FN education and schools. • Adequate, sustainable, and universal funding for FN education systems and schools. • FN-P/T sharing of knowledge, expertise, and other resources as appropriate. • FN control and capacity development for data and information gathering, management and research.

12. Education: Outcomes • Implementation of FN jurisdiction, and the creation of locally-developed FN education systems across Canada.  • Adequate funding to design and implement the five new federal FN education policy directions: • FN jurisdiction over education; • Implementing FN education systems; • Innovations for FN schools; • Performance measurements; and, • Improved educational success for students away from communities. • Adequate, sustainable, and universal funding to FN education systems and schools, updated annually for price and volume over the next ten years. • Improved educational performance for FN learners to levels comparable to their cohorts nationally and internationally, including local language fluency and cultural competence. • Increased funding for Post-Secondary Education to address the pressing backlog and the continuing needs of both FN students and institutions. • P/T support for FN education systems and the sharing of resources, expertise, and capacity, as needed, and where there are complementary jurisdictions.

13. 4. Housing The Challenge • Under the FN-Federal Crown Political Accord and proposed Multilateral Accord, implement FN jurisdiction over housing and infrastructure, and the treaty right to shelter both on and away from communities. • Address critical housing shortage and ensure housing conditions on par with Canadians. • Realize economic development and job creation potential in all areas of housing. • Address recent AG report regarding water quality. The Targets • Eliminate as priority the FN housing backlog (est. 80,000 units). • Adequate, sustainable and accessible funding of FN housing and infrastructure. • Establish the AFN’s proposed comprehensive FN Housing Framework • including a FN National Financial Institute and associated legal framework to provide new financial instruments to meet the housing challenge. • MOU on Transformative Change in FN housing linked to jurisdiction, capacity development and economic prosperity.

14. Housing: Outcomes • Commitment to build and service 80,000 new units through investments in social and home ownership investments. • Improved access and quality of social housing. • New financial modalities to encourage market based housing. • Mobilizing of P/T portion of federal funding transfers allocated for FN housing. • F/P/T recognition of the right of FN communities to provide housing for their citizens wherever they reside (on and away from reserve). • Assist FNs in building and maintaining sustainable housing environments through capacity development. • Transfer housing information, technologies and processes to FNs.

15. 5. Economic Opportunities The Challenge • Under the FN-Federal Crown Political Accord and proposed Multilateral Accord, implement strong FN governments for sustainable economic and social development. • Create fiscal certainty and predictability to attract external economic investments. • Implementation of appropriate mechanisms to support diverse FN economies building on existing regional economies. • Address the high unemployment levels of FN citizens and encourage employment parity with other Canadians. • Mobilize FN youth to meet future national labour shortages. The Immediate Targets • Investments in enhanced procurement, connectivity and fisheries opportunities. • Develop and implement a distinctive national strategy on FN economic growth based on principles of self-government. • Multilateral research on FN training and skills development, demographics, and new economic opportunities. • Agreement to include Economic Opportunities as a full agenda item at the next FMM, with concerted outcomes for a new strategy.

16. Economic Opportunities: Areas for Future Discussion • Sustainable economies that support jurisdiction, capable governing institutions, and cultural match. • FN governments (local and/or regional) with economic systems, services, programs, incentives and capacity that enable greater capacity to determine economic priorities and manage economic growth. • Regional capacity to match economic opportunities with human resources capacities. • Focused incentives for increased economic activity, employment and productivity. • Coordinated employment initiatives designed to better reach youth and make use of enhanced procurement and trade opportunities. • Resource based economic framework to support new interaction between FN business community and resource development.

17. Measuring Results • The UN Human Development Report (2000) states that: • “Statistical indicators are a powerful tool in the struggle for human rights…” • Proposed Indicators to Measure Progress from FMM 05: • Health (FN specific) • Childhood Obesity and Potential Years of Life Lost (PYLL) as an aspect of Life Expectancy and Burden of Disease. • Housing • “Core Housing Need” (CMHC) defined as: Affordability, Suitability, and Adequacy. • Education • Proportion of FN Young Adults with High School or Higher, with sub-components of Employment Rate and Fluency of Local Language. • Economic Development • Employment Rates and Income Levels (to be confirmed). • AFN’s Closing The Gap Reporting Framework identifies 10 additional health determinants and their associated indicators.

18. Agenda Items for Future FMMs • Health Determinants • Economic Development • Environmental Stewardship • Employment • Lands/Resources • Justice/Corrections • Social Services • Languages, Heritage and Culture • Cross-cutting Determinants • Gender • Rural/Urban • On/Away from Reserve Requires a commitment to engage in discussions on the remaining health indicators through a series of FMMs over the next 10 years.

19. Summary Federal Commitments • Overarching: • Recognition and support of FN jurisdiction and institutional capacity through the implementation of a FN specific FPT multilateral framework. • Clear statement of federal responsibilities to FNs. • Specific policies and programs that focus on the unique needs and opportunities of FNs. • Sustainability of current and future investments, including new strategic investments in capital, human resources, infrastructure, and program areas. • Support for FN information and data gathering, and research. • Commitment to a series of FMMs and other partnership processes. • Health: • Escalator and expanded primary care and public health models. • Education: • Support for the implementation of locally-developed FN education systems. • Housing: • New investments, FN National Financial Institute and MOU on transformative change. • Economic Opportunities • Support for a FN-specific national strategy based on self-government.

20. Summary Provincial/Territorial Commitments • Overarching • Recognition and support of FN jurisdiction and institutional capacity through the implementation of an FN specific multilateral framework. • Clear statement of P/T responsibilities to FNs. • Enhanced linkages between P/T and FNs’ services/strategies. • Engagement of FNs in ensuring cultural compatibility of P/T programs and services. • Greater accountability to FNs for FNs’ portion of federal transfers. • Establishment of mutual accountability frameworks in areas of overlapping or complementary jurisdiction. • Support for FN information and research. • Commitment to a series of FMMs & other partnership processes. • Health • Adaptation of P/T services and linkages with infrastructure (telehealth). • Education • Mutual accountability frameworks & sharing of costs, where appropriate. • Housing • Mobilizing P/T portion of federal transfers. • Economic Opportunities • Investments in enhanced procurement and connectivity opportunities.

21. The Cost of Doing Nothing • The costs of investing vs. the cost of doing nothing • Royal Commission on Aboriginal Peoples (RCAP) • RCAP identified the cost of the status quo as $7.5 billion in 1996 due to the net cost of foregone production, the extra cost of remedial programs and financial assistance, and the cost of foregone government revenues. • It estimated that this would climb to $11 billion by 2016 if no changes were made. • Royal Bank of Canada (RBC) • RBC suggested that the costs of implementing RCAP would be more affordable in the long-run than “maintaining the status quo, the truly daunting cost of doing nothing“ (1997). • Human Cost • As the fast growing population in Canada, FN youth need to have the opportunities to contribute to the cultural fabric and overall Canadian economy. Billions of dollars are lost each year through the failure of the country to realize the full potential of First Nations.