Pathway to Health and Wellness:Gathering Wisdom X

Richard Jock, Interim Chief Executive OfficerJanuary 14-16, 2020

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A New Approach to Health Services

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1.Health Benefits Program

2.Primary Health Care

3.Mental Health and Wellness

4.Allocations

5.Community Capital

6.Cultural Safety and Humility

7.Regionalization

Highlighting Our Successes

www.fnha.ca1. Health Benefits: Transitions to Pharmacare and Pacific Blue Cross

www.fnha.caBC Pharmacare Plan WTransition Update

• On October 31, 2017, partnered with BC Pharmacare to implement the new “Plan W”.

• Pharmacare streamlines processes and increasing FNHA’s ability to affect formulary changes going forward.

• An evaluation help inform the transition to Pacific Blue Cross,.

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Recommendations Actions Taken

FNHA should incorporate key lessons into operating policies and plans for similar initiatives

Lessons learned from PlanW transition were instrumental in success of PBC transition

FNHA needs to work with FNs and service providers for improvement to Plan W

HB has Community Engagement Team to support ongoing changes to Plan W and other benefits

FNHA needs to develop ongoing training for client and service providers

HB is implementing plan to support education of providers and improving information to Clients

Plan W Evaluation Recommendations

www.fnha.caPacific Blue Cross Transition Update• Over 9,000 Member Profiles

activated;

• Call centre service standards improved;

• Number of clients accessing benefits increased;

• Dollar amount covered /per claimant increased.

www.fnha.caWe continue to work on:

• Claims processes for Medical Supplies and Equipment

• Trouble shooting service issues• Indigenous Cultural Safety and Humility• Communicating to providers• Community info session• Navigation of PBC app and Member profile• Keeping clients and providers informed

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§ Clients can check coverage by:• Calling Health Benefits at 1-855-

550-5454• Or, by creating an account and

signing in to personalized Member profile at pac.bluecross.ca/fnhaclient

§ Visit fnha.ca/benefits for more info

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The Case for Changing Medical Transportation

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Medical Transportation Project Goals

•Improved client satisfaction, experience, and access•Policy changes •More efficient program delivery •Cost sustainability•Integration with primary care •IT system improvements

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2. Primary Health Care: Our Vision

www.fnha.caFirst Nations Primary Health Care LandscapeLandscape

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Our Primary Health Care Work

• Joint Project Board (FNHA and BC)

• First Nations-led Primary Health Care

• Primary CareNetwork

• Partnerships

www.fnha.caFirst Nations-led PHC Model: Regulated and Traditional Wellness

MOH Funded FNHA Funded• General Practitioner• Nurse Practitioner• Registered Nurse• Licensed Practical Nurse• Physiotherapist• Medical Office Assistant• Mental Health Counsellor• Social Worker• Dietician

• Traditional Healer• Wellness Navigator• Traditional Food Advisor• Elder• Practice Manager/ Quality

www.fnha.caeHealth• Centre for Excellence in Virtual Care

• Ongoing operational support, matching of health and wellness services, and training in virtual health

• Integration with First Nations-led and Primary Care Networks

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www.fnha.ca3. Mental Health and Wellness (MHW)

FNHA Policy Statement on MHWThe FNHA through its relationships and partnerships will ensure that all First Nations people have access to a culturally-safe, comprehensive, coordinated continuum of mental health and wellness approaches that affirms, enables and restores the mental health and wellness of our people, and which contributes to Reconciliation and Nation rebuilding.

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Investments: 2015-2020

www.fnha.caNew MHW Investments

Fiscal Year 2019-2020SDH MOU $15 M

Land-based Treatment $5 M

MW Action Teams $2.1M

PC MHW Liaison $0.72 M

Opioid Action Plan $8 M

MMIWG $0.75 M

Suicide Prevention Life Promotion Collab.

$0.25 M

Fiscal Year 2020-2021

SDH MOU $15 M

Land-basedTreatment

$5 M

MW Action Teams

$2.1 M

PC MHW Liaison $0.72 M

Opioid Action Plan

$8 M

www.fnha.caMental Health and Wellness MOU: Background

Mental Health and Wellness MOU: Background

www.fnha.caStatement of Readiness Update: January 1, 2020

Region # of Statements received

# of communities represented

Interior 10 55

North 9 28

Vancouver Coastal 6 9

Fraser Salish 1 32

Vancouver Island 10 24

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Go Forward Considerations

www.fnha.ca4. AllocationsSummary of Increase to Date

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Region # Participants % engagement Top Three Priorities

Fraser Salish 25 84% #1: 68%-Addictions Worker#2: 65%-Home Care Resource#3: 38%-Nursing Increases

Interior 81 81% #1: 36%-Addictions Worker#2: 33%-Home Care Resources#3: 33% Nursing Increases

North 77 77% #1: 43%-Addictions Worker#2: 33%-Nursing Increases#3: 33%-Home Care Resources

Vancouver Coastal 33 87% #1: 62%-Addictions Worker#2: 43%-Home Care Resources#3: 31%-Nursing Increases

Vancouver Island 60 88% #1: 55%-Addictions Worker#2: 51%-Home Care Resources#3: 43%-Nursing Increases

FY2018-19 Escalator Priorities : Polling Results

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Portfolio Size

• Over $175 Million in assets • Over 150 assets (e.g., buildings)• Over 58,000 m2• Average Asset Size = ~300 m2• Average Age of Asset = 15 years• Average cost grew from $2.8 to $4.3M

5. Community Capital Program

Health care facilities are integral to health care service delivery and have a direct impact on the quality of care.

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A Holistic Approach

• Reflecting communities’ needs and vision

• 28 new facilities built

Before After

Tla-o-qui-aht (Esowista) First Nation, Vancouver Island

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Transformation Opportunities:

• Long-term capital planning• Monetization• FNHA’s role, e.g., from “Funder” to

active participant• Inclusion of Treatment Centres• Standardization• Regional Community Capital envelope• FN Infrastructure Business

www.fnha.ca6. Cultural Safety and Humility

www.fnha.caTripartite Evaluation Case Study Findings: Persistent Challenges

Largest barrier to change:

! Pervasive racism, stereotypes and substandard care.

www.fnha.caHardwiring Cultural Safety and Humility into the System

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Next Steps

• Formalize partner reporting

• Support the Change Leadership Strategy through the Cultural Safety and Humility team

• Complete Cultural Safety and Humility Standard

• Provincial Emergency Departments

• Revising complaints systems

• Refresh FNHA’s Cultural Safety and Humility website

• Ensure FNHA is a leader in Cultural Safety and Humility

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7. Regionalization

www.fnha.caRegionalization to Date

www.fnha.caWhat’s Next?

•Review Medical Transportation

•Greater transparency

•Collaboration/reciprocal accountability

•Effective and timely communications

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