Vertical and Horizontal

Integrated Managementof the Labrador Innu Comprehensive Healing Strategy (LICHS)

Canadian Public Health Association ConferenceJune 3,2008Presenters: Gail Baikie & Barbara Guy

Purpose

• Evolving model of Integrated Management in the Labrador Innu Comprehensive Healing Strategy (LICHS)

• The LICHS context – federal/provincial/Innu relationships

Context

Labrador Innu – Mushuau (pop. 800) and Sheshatshiu (pop.1800)

• Nomadic and geographically isolated until 1960s• Under Terms of Union with Newfoundland (1949) Innu did not come under the

Indian Act• Initial crisis 1990s – leading to Mushuau Innu Relocation Agreement (MIRA)• Mushuau Innu relocate from Davis Inlet to Natuashish in 2002 • 2000 youth gas sniffing crisis in both communities• LICHS (2001-2005) 5 components: community policing, programs and services,

relocation of Davis Inlet to Natuashish, reserve creation and registration under the Indian Act and community health

• Current LICHS (2005 – 2010)

LICHS 2001- 2005 Integrated Structures and Initiatives

• Main Table – tri-partite collaboration, negotiation and info-sharing • Steering committee • LICHS formative evaluation 2003• First design of IM office • Sub-committees of MT• Operational LICHS and community level• Operations Committee

Current LICHS (2005-2010)

Focus:• Horizontal Integrated Management• Capacity Development (Governance & Services)• Physical Infrastructure• Health/Social/Education Programs

First Nation Determinants of Health LICHS Phase II Objectives

InnuWell-being

&Autonomy

Governance & Self-Determination

Lands and ResourcesEconomic Development

Justice/CorrectionsInnu Defined programs

Education Employment

IncomeCulture

Health Programs (e.g. addictions)Social Environment (e.g. safety)

Early Childhood Development (e.g. maternal & child health)Environment (e.g. clean water)

Housing and Infrastructure

Horizontal Integrated Managem

ent

Building a Physical, Social, Health Foundation for Healing & Development

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Integrated Management:Current Structure

• Chief Federal Negotiator Lead on LICHS & Land Claims Maintables• Supported by Director of Integrated Management & Senior Federal Negotiator• LICHS Maintable (tripartite) with sub-committees (Health & Healing, Education, Child Youth

& Family Services) • Federal Interdepartmental Integrated Management Committee

Building Horizontal & Vertical Cooperation and Coordination• Improved relationship and scope of action in federal relationship with Innu and Province• Building relationships across sectors (NGO, Universities….)• Director of Integrated Management – Joint HC & INAC Office (Sept 2007 - ) • Supports Vertical Collaboration between local, regional and national (service delivery,

operations, policy)

Outcomes

• Role of Director: Non-administrative; Functional reporting relationships; Diverse Perspective and Skill Set (Breadth expertise and opposed to depth expertise); A ‘Federal’ Vs ‘Departmental’ perspective

• Major initiatives: Capacity Building; Intoxicant Bylaw; Education and Child Youth Family Services Devolution

• short term: responsiveness has increased, formal avenue for discussion and direction • long term: stronger structure to support linkages. E.g. comprehensive community planning

(INAC) to community health planning (HC) • Benefits to federal government – perception, opportunities, coordinated efforts• Benefits to Innu – mobilized efforts on priorities; one window access• Challenges: Incompatible Administrative Systems; Maintaining the Vision for Integration

(and Collaboration); Building Relationships (informal) but require formal; Relationships are tenuous

• Building on the Past – Responding in the Present – Preparing for the Future

Results - Policy implications

• The lack of a joint program framework, with a comprehensive understanding of roles and potential impact, affected the timeliness of integration work – A ‘Will’ Without the ‘Way’

• Conceptual policy work to support programming and planning linking Innu stated vision for healthy communities, literature on healing and community development, and LICHS goals and programs – From Reactionary to Strategic

• Health and healing are central to the work, are shared objectives, and can be affected by more than programs. Integration has furthered this understanding – From ‘Your’ Responsibility to ‘Our’ Responsibility

Questions