Diinawemaagani toog MINWEYAANIGOZIWIN Shigo Gii-ozaamendang gego awiya

1. DiinawemaaganitoogMINWEYAANIGOZIWINShigoGii-ozaamendanggegoawiyaDiinawemaaganitoogMINWEYAANIGOZIWINShigoGii-ozaamendanggegoawiya ISKATEWIZAAGEGAN NO.39 INDEPENDENT FIRST NATION Kejick Post Office BOX 1 ● Shoal Lake, Ontario ● Canada P0X 1E0 ● Phone: 807.733.3053 ● Fax: 807.733.3106 ● E-mail: Iskatewizaagegan@iifn39.ca Ontario HSIF regional meeting MARCH 26, 2013 THUNDER BAY, Ontario Presented by kienanwilliams

2. Purpose/Outcome • Integrated mental health and addiction service delivery model which combines existing federal and provincially funded health and other services. • Priority of this project is to establish formal relationships through multiple signed agreements with services and organizations in a culturally safe manner, to achieve integration

3. Outcomes continued... • Service agreements will include: • capture roles and responsibilities of each party • clauses respecting First Nation protocols, integrating Traditional Aboriginal healing and improving measurable health outcomes • assurance of the qualifications of those mental health workers • establish protocols with outside service providers for reporting and advising the appropriate community health staff for case management purposes • provide an integrated crisis response for mental health and addiction clients from existing services. • identify which services and organizations should be accessed for support to meet the needs of a client particularly when there is a need to mobilize an integrated service team afterhours.

4. Example: Service Agreements would be signed between the First Nation and individual service providers. • The collective MULTIPLE service agreements provide an integrated continuum of care mental health and addiction service delivery model. • To meet their individual needs, each First Nation may sign agreements with a different selection of service providers. The service providers are funded by the province, the federal government and or the NW LHIN

5. Accomplishments to Date • Active HSIF steering committee with strong commitment from partners and Terms of Reference approved December 4, 2012 (4 meetings to date) • Assessment of Mental Health and Addiction issues; impacts, supports and gaps. • Established baseline re existing Mental and Addiction service providers in area (53 services listed provided by 23 or more organizations): • Awareness of services offered • Whether they network/relationship with service • Do you receive services from the organization • Do you coordinate services • Are there agreements/protocols in place • Do you want to learn more • The provincial partners, federal partners and FN participated in the activity • Can measure changes in level of integration as a result of this activity • Findings – the provincial partners have more formal relationships with each other compared to the relationships between First Nations and the provincial partners. Gap of awareness by FN of many of the provincial services; FN aware and fully utilize federal services. No continuum or formal integration in place.

6. Accomplishments to Date (cont’d) • The purpose of the project is to integrate with mental health and addiction service providers funded by the LHIN, the province and/or FNIH. Iskatewizaagegan Independent First Nation is convinced that the stakeholders on the HSIF steering committee are committed to: • Signing agreements with the First Nation to improve access to services in a culturally meaningful or community appropriate manner. And, • Influencing and leveraging relationships with other provincially, LHINs funded service providers or federally funded services. • Website has been developed: http://www.shoallake39-hsif.ca/ • Traditional Naming Process – engagement of 13 Elders in the HSIF project • 620 Year 1 Status Report of main deliverables prepared and approved by Iskatewizaagegan Independent First Nation Council

7. Partnership Activities • The focus of this integration project is on relationship building to secure signed service agreements. • Relationship building has occurred through individual meetings, focus group sessions and formal steering committee meetings with the federal, provincial and First Nation stakeholders. • The relationships developed with service providers on the Steering Committee are going very well. Already individual providers have shifted where and how they deliver services based on the relationships developed to date. • Iskatewizaagegan Independent First Nation wants to focus project efforts on the practical community work required to obtain these signed agreements and implement services integration rather than on additional committee work that does not necessarily expedite the end product

8. Partnership Activities: Representatives on the HSIF steering committee have been very carefully selected by Iskatewizaagegan Independent First Nation in the planning stage to achieve the following • That participating First Nations can engage with and access higher level qualified and accredited professionals in the field of mental health and addictions, (such as the ACTT), with whom they might not already have a strong relationship. • Enhance knowledge transfer whereby the larger stakeholders (such as Lake of the Woods Hospital) advise the participating First Nations of other service providers they access to provide their integrated system of care and assist the First Nations in establishing a relationship with or gain access to those services. And, • Access to Steering committee members areas of influence such as standing advisory committees, regional meetings, ad hoc working groups, regulatory bodies, communication infrastructure (that were previously unavailable to many First Nations). • Information sharing from primary care Aboriginal organizations who are members of broader province-wide organizations (including Migisi, WaasegiizhigNanaandawe’iyewigamig Health Access Centre and Treaty 3 Police) to access their policies, procedures, training manuals, protocols and guidelines with respect to cultural and client safety when working in the field of mental health and addictions.

9. Challenges and Possible Solutions • In our initial proposal submission, the funder removed a task designed to determine mandates of each mental health and addictions service provider. The information we have been provided regarding mandates is incomplete/inaccurate. HSIF steering committee members feel that for this integration project and to enhance their own service delivery that it is imperative that to have a better understanding of the mandate of the mental health and addiction service providers in the area. (It is challenging to integrate if you do not know the mandate of the service providers). We would like to include this step in our deliverables for the project. • Relationship building is a key step in this project and it is important to respect the formal and informal protocols being developed and not inadvertently politicize it. • The funder has to be careful with some of it’s activities with the project which has the potential of undermining First Nation ownership.

10. Lessons Learned / Approaches • A collaborative and compassionate approach to engaging those service providers in Minweyaanigoziwin who do not usually work with the participating First Nations. • There are many funded services in the Kenora area currently not being accessed by the First Nations. • Assumptions by some that three of the 20+ organizations and more than 53 different types of mental health and addiction services should be “the only service provider” • First Nations want options and variety of services available from the other providers. • Non-Aboriginal Service providers will only come if invited.

11. Upcoming Activities • Feasting the project (May 24, 2013). • The Steering Committee is taking a community based, pragmatic approach to determining the service model rather than excessive ongoing analysis about the type/ prevalence of mental health and addiction issues faced by the community members, and examining theoretically who would be a good fit for service provision at the committee level. • The Steering Committee has decided that the most effective next step is to begin with one First Nation (Iskatewizaagegan Independent First Nation) to develop the continuum of care and service agreements and then broaden to other First Nations. First Nations will be briefed both through Steering Committee meetings as well as annual focus groups and individual meetings with the Project Lead.

12. Upcoming Activities (cont’d) • 15 service providers (federal and provincial) will be meeting in Iskatewizaagegan Independent First Nation in Juneto identify services and areas of integration with the formal service agreements signed in June and integrated service delivery being provided by September 2013. • 5 already have an relationship (but no formal service agreement) and 10 will be providing new services in an integrated continuum of mental health and addictions service delivery. • All will be integrating with the existing Brighter Futures, Building Healthy Communities and NNADAP services at the community level. • This will then be replicated with other participating area First Nations.

13. Miigwetch