How are we working together?
The Tripartite Framework Agreement on First Nations Health Governance (the Framework Agreement) was signed in 2011 by the provincial government, federal government, and BC First Nations, and endorsed by the First Nations Health Council (FNHC). Several committees have been established under the Framework Agreement:
- Implementation Committee, which monitors the implementation of the Framework Agreement and the effectiveness of the health governance structure;
- Political Principals, which consists of the tripartite political leads and provides executive direction and governance oversight; and
- The Tripartite Committee on First Nations Health, which monitors tripartite progress towards improving health and wellness.
The tripartite partners are near completion of the second five-year evaluation of the implementation of the Framework Agreement, covering the period from 2019-2023.
The Ministry of Health is working with the Ministry of Indigenous Relations and Reconciliation and the Declaration Act Secretariat to ensure meaningful engagement with Modern Treaty Nations and the Province’s distinct relationship with Modern Treaty Nations is upheld through this process.
Are there challenges?
There is a growing interest from individual First Nations in engaging directly with the Ministry of Health to explore government-to-government relationships and supports that align with their self-determined priorities. Establishing spaces that enable meaningful joint decision-making at local, regional, and provincial levels is a complex and evolving process. Efforts are underway to support coordination across sectors, regions, and governance structures. The tripartite partners are conducting a comprehensive evaluation of progress on implementing the Framework Agreement covering the period 2019-2023. The evaluation report is slated for public release in Summer 2025.
FNHC has been engaging with First Nations to inform the development of two consensus papers that were originally intended for consideration at Gathering Wisdom XIII (13) in June 2025:
- B.C. First Nations-specific principles to guide provincial and federal health-related legislation; and
- Evolving FNHC’s role and governance structure within the broader First Nations Health Governance Structure, to reflect input from evaluation participants as well as FNHC’s updated focus to move from transfer to transformation.
To allow for more engagement and build consensus on these complex topics, the First Nations Health Authority has extended the engagement timeline. The engagement process will continue throughout Fall 2025 and Spring 2026 to continue to build consensus across communities.
Highlights
Renewed Fraser Partnership Accord
In February 2024, the Province renewed its commitment with the Fraser Salish Regional Caucus, Métis Nation British Columbia and Fraser Health to improve health outcomes for Indigenous Peoples in the Fraser Salish region. The Fraser Partnership Accord has been amended to include the Fraser Salish Regional Caucus and, for the first time, Métis Nation BC, as signatories and full and equal partners in decision-making and service delivery at local and regional levels. The accord was first signed in 2011 and amended in 2020, and aims to blend cultural and modern health practices to improve health and wellness for all people in B.C.
A core element of the new accord is the creation of an Indigenous Health Collaborative Council that will serve as a joint decision-making body to provide governance for Indigenous health services in the region and programs to ensure that general health services provided by Fraser Health are culturally safe and free from Indigenous-specific racism.
The accord seeks to achieve the commitments regarding health and the social determinants of health made in the Declaration Act Action Plan. The partners to this accord endorse and commit to work to implement the United Nations Declaration on the Rights of Indigenous Peoples and aim to establish a culturally safe health care system in B.C. that is free of Indigenous-specific racism through the implementation of advice and recommendations made in the In Plain Sight report. For more information, read the “Renewed partnership improves health, wellness for Indigenous Peoples” news release.